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COPYRIGHT DEPOSIT. 



V 



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The Therapeutical Applications 

of 

Peroxide of Hydrogen 

(MEDICINAL). 

Glycozone 
Hydrozone 

AND 

Eye Balsam 

/ BY 

CHARLES MARCHAND, Chemist, 

GRADUATE OF THE l *ECOLE CENTRALE DES ARTS ET MANUFACTURES 
DE PARIS" (FRANCE). 







TREATMENT OF DISEASES CAUSED 



BY 



GERMS, BACTERIA, MICROBES. 



TWELFTH EDITION. 



NEW YORK. 
1897. 



<\\cl>*4 



^ 










Copyright 1897, BY Charles Marchanp. 



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TO THE MEDICAL PROFESSION 



I respectfully call your attention to the fact that I manufacture 
Hydrozone at the request of the leading Medical Profession, whom 
experience has taught, that in the treatment of many diseases caused 
by pathogenic germs, the bactericide power of my Peroxide of 
Hydrogen (medicinal), 15 volumes, is not always sufficient to thor- 
oughly destroy at once the microbian element, which frequently de- 
velops with such prodigious rapidity, that it is urgent to check and 
overcome its virulence in the shortest possible time, so as to prevent 
the whole system of economy from being invaded by ptomaines. 

Hydrozone yields 30 times its own volume of Nascent Oxygen 
(near to the condition of Ozone) and it is far superior to my Peroxide 
of Hydrogen (medicinal), in healing properties. 

Hydrozone retains its germicide and curative power for any 
length of time when kept with ordinary care. 

It is slightly acid to the taste, and it should never be made gieu- 
tral before using, even in the treatment of diseases of the most deli- 
cate mucous membrane. 

A host of imitators and substitutors of drugs are filling prescrip- 
tions with commercial Peroxide of Hydrogen, which is good enough 
for bleaching purposes, but totally unfit, unsafe and worthless as a 
remedy. 

They claim that it is just as good as the genuine article, but they 
take great care not to say, that this cheap article which I sell in 
bulk at four cents per pound leaves them a profit varying from 500 to 
1,000 per cent. 



By so doing, substitutors of drugs place the physician's repu- 
tation as well as the life of his patient in jeopardy, and the only 
effective manner of checking this fraudulent business is to expose 
them through Medical Journals and Daily Papers. 

This course, which is already followed by several manufacturers 
of legitimate preparations will benefit the honest druggists, the phy- 
sicians and their patients. 

In order to protect the Profession against fraud, my medicinal 
preparations are put up only as follows: 

Hydrozone. — (30 volumes preserved H2O2 solution) : Extra- 
small size (for Dentists), small, medium and large size bottles, bear- 
ing a red label, white letters, blue and gold border, with my signature. 

Charles Marchand's Peroxide of Hydrogen (Medicinal) 
(15 Vol. H 2 2 ): — jL lb., % lb., y 2 lb., 1 lb. bottles, bearing a blue 
label, white letters, red and gold border with my signature. 

Glycozone:— X l°-> X A lb., 1 lb., bottles, bearing a dark yellow 
label, white and black letters, red and gold border, with my signature. 

Marchand's Eye Balsam:— One size bottle packed in a box, 
sealed with my signature. 

Please prescribe in original, unbroken package, to avoid imita- 
tions and disappointment. 

Yours respectfully, 




Ckemist and Graduate of the "Ecole Centra le des Arts et 
Manufactures de Paris' {France). 



TO THE MEDICAL PROFESSION. 



The present edition of this book contains the directions for using 
Hydrozone, Glycozone and Eye Balsam. 

Hydrozone being a 30 volume aqueous solution of H 2 2 is twice as strong 
as my medicinal Peroxide of Hydrogen (15 volumes). Therefore when my 
medicinal Peroxide is prescribed the dose should be at least double in order 
to obtain the same effect. 

Physicians are earnestly requested to use Hydrozone in preference to my 
medicinal Peroxide, not only on account of its wonderful bactericide power, 
but also owing to its being far superior in stimulating and healing action 
upon diseased tissues. 

CONTENTS. 



Page. 

Abscesses 55 

Abscess of the Vagina. — Treatment.. 61 
— Acne — Pimples on the Face — Treat- 
ment 64 

Action of Hydrozone upon Animal 

Cells and Vegetable Cells 7 

Action of Hydrozone upon Diseased 

Surfaces 8 

Alveolar Abscess and Abscess of the 

Inferior Maxilla — Treatment 52 

Analysis of the Different Brands of 
Peroxide of Hydrogen (medicinal) 
Found on the Market, and their Re- 
spective Keeping Properties, by Dr. 

H Endemann 1 

See also articles headed: 
"Hydrogen Dioxide H2 O2," by 

Prof. L. D. Kastenbine 154 

Peroxide of Hydrogen, by Dr. J. P. 

Parker IV 

Anthrax — Carbuncle — Treatment .... 56 

Asthma — Treatment 22 

Barber's Itch 63 

Bladder-( Inflammatory Diseases of the) 62 

Blepharitis 50 

Bronchitis — Treatment ....... 23 

See also article by: 

Dr. Douglas H. Stewart 186 

Cancerous Sores — Treatment 57 

Carbolic Acid-Its Dangers-(foot note), 10 



Page. 

Catarrh of the Nose and Catarrh of the 

Throat — Treatment 15 

See also articles by: 

Dr. Clarence C. Rice 145 

Dr. Alex. Rixa 176 

Dr. W. Ellery Briggs 207 

The Uses of Peroxide of Hydrogen in 
Diseases of the Nose, Throat and 
Ear, by Dr. W. Scheppegrell 224 

Catarrh of the Stomach or Gastritis, 
(Chronic or Recent) — Treatment. . 

34, 35, 36, 37 

See also articles headed: 

Diseases of the Alimentary Canal, 

by Dr. J. O. DeCourcy 156 

Chronic Gastritis of Long Standing, 
with Periodic Attacks of Migraine, 
by Dr. G. A. Curriden 214 

Treatment of Inflammatory Diseases 
of the Stomach, by Dr. G. A. Blech,2i7 

Hydrozone in Gastric and Intestinal 
Disorders, by Dr. John Aulde, ... 2 16 

Local Treatment of Chronic Gastric 
Catarrh. A Clinical Lecture by Dr. 
J. M. G. Carter 236 

Mechanical Feeding in the Insane, by 
Dr. Frank C. Hoyt 237 

Cholera Infantum 48, 185, 190 

Cholera — Its Prevention and Treat- 
ment, by Elmer Lee, A. M., M. D.,160 



CONTENTS 

Page. 
See also article by Dr. Cyrus Edson, 44 

Comparative Chemical Reactions Be- 
tween Hydrozone and Ozone '. 6 

Comparative Tests of the Bactericide 
Power of Antiseptics 9 

Conjunctivitis (Catarrhal) or Ophthal- 
mia — Causes — Treatment 48 

Conjunctivitis (Purulent) — Ophthalmia 
Neonatorum, or Ophthalmia in Chil- 
dren — Treatment , 50 

See also articles headed : The Neces- 
sary Peroxide of Hydrogen, by Dr. 
Robert T. Morris 72 

Peroxide of Hydrogen in Conjuncti- 
vitis 154 

Constipation — Treatment 38 

Consumption — Phthisis — Tuberculosis 
of the Lungs — Causes — Treatment 26 
See also: A Practical Theory and 
Treatment of Pulmonary Tubercu- 
losis, by Dr. Frank S. Parsons, Ab- 
stract from the Philadelphia Medical 
Ti?nes and Register 179 

Contagious Diseases of the Alimentary 

Canal 39 

See also articles by: 

Dr. Cyrus Edson 44 

Dr. Elmer Lee 39-160 

Dr. Jas. Osbourn DeCourcy 156 

Coryza — Treatment 19 

Croup, Membranous Croup — Causes 
and Treatment 24 

Cystitis (Purulent) — Treatment 62 

See also articles headed: 

The Necessary Peroxide of Hydrogen, 
by Dr. R. T. Morris 72 

Peroxide of Hydrogen in Gynecology 
and in Obstetrics, by Dr. Egbert H. 
Grandin 79 

Hydrozone for Disorders of the Genito- 
urinary Tract, by Dr. John Aulde, 229 

Dandruff 64 



(Continued.) 

Page. 
Destructive Action of Ozone upon the 

Germs and Virus 4 

Diarrhoea — Treatment 38 

Diphtheria — Causes — Treatment 29 

See also articles by: 

Dr. G. F. Adams 82 

Dr. Edward J. Bernstein 81 

Dr. A. B. Clay 228 

Dr. Geo. B. Hope 65 

Dr. Pervical Lantz \\\ 

Dr. E. Lawrence Linder. 219 

Dr. I. N. Love 97 

Dr. J. Mount Bleyer 67 

Dr. W. S. Mullins 88 

Dr. David Phillips 75 

Dr. S. H. Sherman 104 

Dr. J. Lewis Smith 96 

Dr. E. R. Squibb 68 

Dr. Wm. F. Waugh 82 

Dr. A. Weber 188 

Dr. J . Osbourn DeCourcy 202 

Directions for Applying Hydrozone 
and Glycozone in the Treatment of 

Diseases Caused by Germs 15 

Diseases of the Stomach 34 

Diseases Caused bv Germs or Microbes, 3 

Dysentery 48 

Dyspepsia Predisposing Causes. 

Treatment 34 

See also abstract from The American 

Text Book of Gynecology 207 

See also pp. 156, 214, 216, 217, 236, 237. 
Ear (Inflammatory and Purulent Dis- 
eases of the) — Treatment 51 

See also article by Dr. Walter B. 

Johnson 108 

Hydrozone in the Treatment of Otitis 

Media, by Dr.Wm. Clarence Boteler,2ii 
The Uses of Peroxide of Hydrogen in 
Diseases of the Nose, Throat and 

Ear, by Dr. W. Scheppegrell 224 

Eczema — Treatment 63 



CONTENTS. 

Page. 

Empyema 57 

Empyema — Wound Closure After the 
Empyema Operation, by Dr. Chas. 

W. Aitkin 98 

An Interesting Case of Empyema 

by Dr. H. F. Brownlee 99 

Erysipelas — Treatment 63 

Eye Balsam — Composition 4S 

Eye (Inflammatory and Contagious 

Diseases of the) — Treatment 4S 

Fistula-in-Ano — Treatment 58 

See also article headed: The Opera- 
tive Treatment of Fistula-in-Ano, 

by Dr. Lewis H. Adler, Jr 109 

Fistula (Recto -Vaginal) — Treatment . . 62 

Freckles and Moth Patches 64 

Gangrenous Sores — Treatment 57 

Gastritis 34~37 

Gastric Ulcer 37~38 

Gleet 59 

Glycozone — Important Information — 

Composition 11 

Glycozone — Composition and Charac- 
teristics, (The Therapeutics of) by 

Dr. Cyrus Edson 12 

Gonorrhoea — Causes and Treatment . , 59 
See also articles by: 

Dr. John J. Sullivan 125 

Dr. R. Charest 69 

Dr. Wm. Roberts 100 

Dr. Egbert H. Grandin 79 

Dr. John Aulde 229 

Granular Eyelids— Treatment 50 

Hand Atomizer and Ozonizer (Descrip- 
tion and Illustrations) 31—32—33 

Hay Fever — Causes — Treatment. ... 19 
See also article headed: New Thera- 
peutics in Hay Fever, by Dr. Alex- 
ander Rixa 176 

Herpes Zoster or Zona 64 

Hoarseness 24 

Hydrogen Peroxide in Contagious Dis- 
eases, by Dr. Cyrus Edson 44 



(Continued.) 

Page. 
Hydrogen Peroxide as a Haemostatic 

by Dr. M. F. Coomes 225 

Hydrozone in Dental Surgery (Uses 

of) 52 

Hydrozone as a Mouth and Tooth 

Wash 55 

Hydrozone as a Preventive for Con- 
tagious Diseases of the Genito-Urin- 

ary Organs. (Note) 60 

Important Information on Peroxide of 

Hydrogen and Hydrozone 6 

Indigestion — Vomiting in Pregnancy 

— Treatment 38 

Inflammatory and Infectious Diseases 
of the Genito-Urinary Organs — Gon- 
orrhoea — Gleet — Urethritis, etc. . . . 59 
See also articles by: 

Dr. R. Charest 69 

Dr. Egbert H. Grandin 79 

Dr. W. S. Mullins 88 

Dr. C. A. Phillips 87 

William Roberts 100 

Dr. John J. Sullivan 125 

Dr. Charles P. Wagar 206 

Dr. John Aulde 229 

Inflammatory Diseases of the Intes- 
tines — Chronic Constipation — Diar- 
rhoea — Treatment 38 

Influenza — LaGrippe — Treatment. ... 21 

Itch — Treatment 63 

Laceration — Inflammation and Ulcer- 
ation of the Gums — Treatment. ... 53 

Laryngitis — Treatment 24 

Leucorrhcea — Treatment 60 

List of Contributors to Medical Liter- 
ature v 

Lupus — Treatment 5 7 

Necrosis and Caries of the Teeth — 

Treatment 54 

Open Sores 55 

Opinion of the Medical Profession, 65-238 
Ophthalmia in Children — Treatment. 50 
Ozoena, or Putrid Catarrh of the Nose, 18 



CONTENTS, 

Page. 

Pelvic Abscess 61 

Phagedenic Chancre of the Rectum- 
Treatment 58 

Pharyngitis — Treatment 24 

Piles (External) — Treatment 59 

Piles (Internal) — Treatment 59 

Poisoning Ivy 63 

See also articles by: 

Dr. N. H. Haight 102 

Dr. R. M. Clark 192 

Predisposition to Disease . . 3 

Psoriasis 64 

Relations of Bacteria to Disease 1 

Rigg's Disease or Loosening of the 

Teeth 54 

See also, The Successful Treatment 

of Rigg's Disease, by: 

Dr. H. E. Lewis 180 

Rose Cold — Treatment 19 

Salt Rheum 64 

Scarlet Fever — Causes — Treatment . 30 

See also articles headed: Scarlet 

Fever, by: 

Dr. J. S. Kennedy 173 

Dr. A. Caldwell 189 

Scarlatinal Diphtheria, by Dr. Wm. F. 

Waugh 82 

Skin Diseases 63 

Sore Throat Angina Tonsilitis — 

Quinsy, etc. — Treatment 29 

Stomatitis 53 

Sun Burn 63 

Teething 55 

Throat (Inflammatory Diseases of 

the) 29 

Typhoid Fever Typhus Yellow 

Fever — Cholera Infantum — Asiatic 

Cholera — Treatment 39 

See also articles by: 

Dr. M. A. Clark 150 



(Concluded.) 

Page. 

Dr. Cyrus Edson 44 

Dr. Elmer Lee 39, 160-193 

Dr. F. H . Wiggin 92-1 1 1 

Dr. Jas. Osbourn DeCourcy 156 

Dr. G. Blech 185-199 

Dr. I. N. Love .190 

Ulceration of the Rectum — Treatment, 58 
See article by Dr. J. M. Mathews. .141 

Ulcers (Chronic and Acute) 55 

See also articles headed: 
Treatment of Acute and Chronic 
Ulcers, by Dr. J. O. De Courcy. . .147 
The Necessary Peroxide of Hydro- 
gen, by Dr. Robert T. Morris 72 

H 2 2 ; an Indispensable Wound 
Sterilizer, by Dr. Geo. H. Pierce. .106 
Thiersch's Grafts in Extensive De- 
struction of Soft Parts about Large 

Joints, by Dr. Henry W. Coe 169 

Urethritis 59 

Vaginitis Metritis — Endometritis — 

Ulceration of the Cervix-Uteri — 

Treatment 61 

See also articles by: 

Dr. Egbert H. Grandin 79 

Dr. Walter S. Wells 163 

Dr. Herman L. Collyer 126 

Dr. W. C. Wile 167 

Dr. John Aulde 229 

Whites, Leucorrhoea, etc. — Treatment 60 
Whooping Cough — Causes and Treat- 
ment 25 

See also article headed: Rational 
Treatment of Pertussis, by Dr. F. 

T. B. Fest 197 

Women's Weaknesses 60 

Yellow Fever — Causes — Treatment ... 47 
See also article headed: 
Hydrogen in Contagious Diseases, 
by Dr. Cyrus Edson 44 



STANDARD 

FOR 

CHARLES MARCHAND'S 

Peroxide of Hydrogen, 

(MEDICINAL) 

•AND 

Hydrozone. 

First — Free from soluble salts. 

Second — Free acid contained in ioo cubic centimetres requires 
not less than i c. c. and not more than three c. c. of normal volu- 
metric soda solution, to be neutralized. 

Third — Peroxide of Hydrogen yields not less than 15 volumes of 
available nascent oxygen. It contains 4.5% of anhydrous H s 2 . 
Hydrozone yields not less than 30 volumes of available nascent oxygen. 
It contains 9% of anhydrous H 2 2 . 

Test. — One cubic centimetre of Peroxide of Hydrogen diluted with 
150 c. c. of distilled water, containing 2 c. c. of C. P. sulphuric acid de- 
colorizes at least 15 cubic centimetres of a solution containing 
5,665 grammes of C. P. permanganate of potash, per liter of distilled 
water. 

One c. c. of Hydrozone being submitted to the above test decolor- 
izes at least 30 C. C. of the same solution of permanganate of potash. 

Marchand's Peroxide of Hydrogen and Hydrozone retain their 
strength for any length of time, when kept in stock with ordinary care 
at a temperature not exceeding 70 F. 

Prepared only by 

Chemist and Graduate of the' ' Ecole Centrale desA rts et Manufactures de Paris '(France. ) 

NOTE. — One cubic centimetre of "Hydrozone" is equiva- 
lent in bactericide power, to two cubic centimeters of my medi- 
cinal Peroxide of Hydrogen and is far superior as a healing 
agent. See p. 6: Important information on Peroxide ot 
Hydrogen and Hydrozone. 




L. D. KASTENBINE, A. M., M. D. 

Professor of Chemistry, Urinology, and Medical Jurisprudence, 

Louisville Medical College; Professor of Chemistry, 

Louisville College of Pharmacy, 

Reports as follows in the Louisville Medical Monthly for July, 1894: 

(See article headed "Hydrogen Dioxide," H 2 3 , page 154.) 

Of the various brands of Hydrogen Dioxides I have examined, 
I find Marchand's to be the one which yields the largest amount of 
available oxygen under all conditions of -exposure, about fifteen vol- 
umes, and the one which contains the minimum percentage of free 
acid. All the marketable articles I have seen are free from barium 
compounds, but the majority do not come up to the 15 volume stand- 
ard, but are 6, 8, 10 and 12 volume solutions. * * * 

The above statement is strongly confirmed by the following 
report : 

THE REAL VALUE OF THE MEDICINAL PEROXIDE 

OF HYDROGEN PREPARATIONS FOUND 

IN THE MARKET. 

By H. ENDEMANN, Ph. D., Chemist, of New York. 

Formerly Associate Chemist to the New York City Board of Health. 

Published by the Times and Register, of Philadelphia, Pa., Dec. 15, 1894. 

My attention having repeatedly been called to several reports 
and analyses made by different chemists and published by some 
medical journals, I concluded to examine all the brands of peroxide 
of hydrogen which I could find on the market, in order to ascertain 
the real value of each when intended to be used as an antiseptic 
remedy, both internally and externally. 

The reports on the subject which have come to my knowledge 
are quite contradictory, and my object is to impart to the medical 
profession the results of my experiments, which have been made on 
fourteen fresh samples, purchased by me in duplicate, directly from 
the manufacturers or their selling agents. 



These brands have been tested for the volume of available oxy- 
gen, the amount of residue, the degree of acidity, and the amount' of 
soluble baryta salts contained therein, as per following table: 



St 



BRANDS OF 
H 2 Q 2 SOLUTIONS. 



~ m c e oj 
<- So & 



I c S B g 

snip's 



§2 

£^"> 
2 S £ 
l * Hl o bo 

c."H o 
"S * N 

Ofv rt 
««*- 1) 

5 °' C 



u>s 



<« O'B 

3 c « . 



fSS ° 
>>>» 5 

« rt . 
0QO3U 

None 



No. i. 

No. 2 

No. 3. 

No. 4 . 

No. 5. 

No. 6. 

No. 7 . 

No. 8. 

No. 9. 

No. 10. 

No. 11. 

No. 12. 

No. 13. 

No. 14. 



John Bene's 

Hydrozone . 

Larkin & Scheffer's 



H 2 Og( Medicinal) 
•• 

H2O2 (Medicinal) 



Mallinckrodt's 

Marchand's 

McKesson & Robbins 
Merck & Co.'s 
Oakland Chemical Co.'s 
Peuchot's 

Powers & Weightman's 
Pyrozone, 3 per cent. 
Rosengarten & Son's 
Smith, Kline & French Co.'s 
E. R. Squibb's 



10.50 
27-35 

9-55 

J 6.55 

10.95 

0.50 
10.50 
10.60 

8.40 
11.20 

3.10 

6.15 
12.40 



0.1886 
0.2180 

0.1206 

0.1408 
0.0564 
0.0540 
0.2418 
0.0382 
0.4674 
0.0830 
0.0534 
0.1002 



2.19 

3- 11 

6.75 

1-43 
I.29 

0.44 
4-57 
0-34 
1.77 
2.03 
0.76 
0.25 
2.6 
12.04 



0.0017 
0.0018 
None 



By referring to this table it is easily understood that sample No. 
2, "Hydrozone" is far superior to any other brand which I have ever 
examined. 

When Hydrozone is diluted with distilled water, in the propor- 
tion of half and half, the resulting mixture contains about 13.5 vol- 
umes of available oxygen, and its bactericide power still remains the 
same as the bactericide power of Sample No. 5, which contains 16.55 
volumes of available oxygen. 

Sample No. 14 comes next to sample No. 5, but it is readily seen 
that the degree of acidity is entirely too large for a preparation 
which is to be applied to the most sensitive diseased mucous mem- 
branes. 



Ill 

Acidity. — The 14 brands which I have examined contain free 
acids (phosphoric, sulphuric, muriatic) ; and I must say that Peroxide 
of Hydrogen (medicinal) should never be made neutral before using, 
even in the most delicate cases: Neutral Peroxide of Hydrogen 
rapidly decomposes under all conditions of exposure. 

The keeping properties of H 2 2 solutions vary a great deal with 
the degree of purity and the percentage of free acids contained 
therein. 

If the proportion of acid is too large, the profession well know 
that it acts as an irritant upon diseased surfaces. If it is too small 
the solution don't keep well. 

My opinion is, that a standard solution of medicinal H 2 O g must 
answer the following tests: 

1. It should contain at least 15 volumes of available oxygen. 

2. The quantity of free acids contained in 100 cubic centimeters 
should require not less than 1 c. c. and not more than 3 c. c. of nor- 
mal volumetric soda solution, to be made neutral. Such a small 
quantity of free acid is not objectionable. 

3. It should not contain any soluble baryta salts. 

4. It must be free from sediment. 

It is to be noticed that brands No. 7 and No. 12 are valueless. 

The brands No. 8 and No 9 are not fit for medicinal uses, 
owing to the fact that they contain soluble baryta salts. 

The brand No. 3 has a heavy sediment of sulphate of baryta, 
which may be considered inert towards the system, but it is certainly 
detrimental to the keeping qualities of this preparation. 

Brand No. 14 which is sold as a ten volume solution, is really 
twelve volumes, but it is too acid. 

Brand No. 5 which is sold as a fifteen volume solution, 
is really 16.55 volumes, viz.: About ten per cent, above the 
standard. 

The brand No. 2, "Hydrozone," which is sold without any 
mention of volume, is really a 27.35 volume solution, viz.: 
Ninety per cent, above the standard. 

None of the other brands come up to the standard, but 
on the contrary they run from 35 to 55 per cent, below. 

N t ote. — Dr. H. Endemann in his subsequent report headed: 
"The Keeping Qualities of the Various brands of Peroxide of 
Hydrogen," published by the Philadelphia Medical Times and Register, 
March 2, 1895, writes: 

"All the above samples having been kept for three months in the 
dark at a temperature ranging between 63 degrees and 52 degrees F., 
the only brand which still answers to the standard is the No. 5 (14.90 
volumes.) 



Brand No. 2, "Hydrozone," which was 27.35 volumes in November, 
(90 per cent above the standard) showed 25.90 volumes when retested 
in February, 1895 (about three times as strong as brands Nos. 1,3, 4, 
8, 9, 11, 14), consequently its high degree of strength as well as its 
keeping properties are thoroughly reliable. 

My opinion concerning Peroxide of Hydrogen for medicinal pur- 
pose is, that strong solutions will soon be exclusively in use, as I con- 
sider that even a 15-volume solution is not always powerful enough. 
Should this strength be sufficient in many cases, the 27 or 30 volume 
solution can easily be reduced to 15 volumes, so that the strong solu- 
tion will answer all requirements." 

The above reports were confirmed by a letter from Dr. 
Endemann, which appeared in the "Times and Register," 
for July 13, 1895. 

PEROXIDE OF HYDROGEN. 

By J. P. Parker, Ph. G., M. D„, of St. Louis, Mo. 

(Published by the Annals of Ophthalmology and Otology, of 
St. Louis, Mo., for April, 1895). 

(Abstract from The Times and Register, June 8th, 1895). 

I have used Peroxide of Hydrogen quite extensively for cleansing 
discharging ears, the nasal and accessory cavities, and have tried all 
the brands of the preparation in the market, and once thought one 
manufacturer's make as good as that of another, and bought the cheapest 
as a matter of economy, but recent experience has taught me that the 
difference in quality is greater than the difference in price. After an 
unpleasant experience with a solution of Peroxide of Hydrogen which 
severely injured the mucous membrane, I bought and examined, chem- 
ically, a bottle of each preparation of H 2 2 in the market and was 
surprised to find so much difference. Some are useless, and others 
worse than useless because they contain too little available oxygen 
and too much free acids (phosphoric, sulphuric, hydrochloric). I now 
order Marchand's (medicinal) exclusively because I find it contains the 
desired quantity of available oxygen and not enough free acid to be 
objectionable, and its keeping properties are all that could be desired. 
By inquiry I learn that Marchand's is the preparation that is used 
by almost all surgeons, and it is considered by them the standard. 

My personal experience with Peroxide of Hydrogen confirms entirely the statement 
of Dr. J. P. Parker, I have used exclusively Marchand's brand until lately, when I ex- 
perimented with Hydrozone. Then I gave up entirely the use of Peroxide of Hydrogen 
and use Hydrozone on account of its strength, which cannot be compared with any 
other brand, even Marchand's. I must say that the results which I obtained with 
Hydrozone are most gratifying. — Ed. 



LIST OF CONTRIBUTORS 

TO 

MEDICAL LITERATURE. 



PAGE. 

G. F. Adams, M. D., of Pulaski, N. Y., "Hydrogen Peroxide in Diphtheria". . 82 
Lewis H. Adler, Jr., M. D., of Philadelphia, Pa., "The Operative Treatment of 

Fistula-in-Ano" *. 109 

Charles W. Aitkin, M. D., of Flemingsburg, Ky., "Wound Closure After the 

Empyema Operation" 98 

American Text Book of Gynecology "Treatment of Neuralgic Variety of 

Dysmenorrhcea" (abstract) . : 207 

John Aulde, M. D., of Philadelphia, Pa., "Hydrogen Dioxide; a Resume" 76 

Substitution and Its Attendant Evils" , 93 

Hydrozone in Gastric and Intestinal Disorders" 216 

"Hydrozone for Disorders of the Genito-Urinary Tract" 229 

Bacteriological World (editorial,) Battle Creek, Mich., "Hydrogen Peroxide 

in Pelvic Abscess" 94 

Edw. J. Bernstein, M. D.,of Baltimore, Md., "Diphtheria and the Use of Hy- 
drogen Dioxide in its Treatment" 81 

Gustavus Blech, M. D., of Detroit, Mich., "Rational Therapeutics of Cholera 

Infantum" 185 

"Medicinal Treatment of Typhoid Fever" 199 

' 'Can Antitoxin Statistics be Relied Upon ?" 210 

"Treatment of Inflammatory Diseases of the Stomach" 217 

J. Mount Bleyer, M. D., of New York, "Some Practical Hints in Connection 
with Intubation of the Larynx, and a Resume of 206 Cases of Diphtheria Oper- 
ated on from 1886 to 1888" 67 

Wm. C. Boteler, M. D., of Kansas City, Mo., "Hydrozone in Purulent Otitis 

Media" 211 

Wm. Ellery Briggs, M. D., of Sacramento, Cal., "Diagnosis and Treatment of 

the Diseases of the Accessory Sinuses of the Nose" 207 

F. H. Brobst, M. D., of Reading, Pa., "Report of a Case of Extensive Gunshot 

Wound" 175 

Mortimer H. Brown, M. D., of Holcomb, 111., "Acute Glossitis" 191 

Warren Brown, M. D., of Tacoma, Wash., "Peroxide of Hydrogen" 212 

H. F. Brownlee, M. D., of Danbury, Conn., "An Interesting Case of Empyema 

with Special Reference to the Use of Peroxide of Hydrogen" 99 

Albert H. Buck, M. D., of New York City, "Diseases of the Ear, "(Abstract from 

"Twentieth Century Practice of Medicine") 215 

A. G. Caldwell, M. D., of Ballardville, Ky., "Scarlet Fever" 189 

1 ' Mammary Abscess" 227 

J. M. G. Carter, M. D., Sc. D., Ph. D., of Chicago, 111., "Local Treatment of 

Chronic Gastric Catarrh. — A Clinical Lecture" 236 

R. Charest, M. D., of St. Cloud, Minn., "Peroxide of Hydrogen for Gonorrhea" 69 

R. M. Chase, D. D.S., M. D., of Bethel, Vt., "Dental Medicine" 94 

M. A. Clark, A. M., M. D., of Barnesville, Ga., "The Treatment of Typhoid 
Fever" 1 50 



R. M. Clark, M. D., of Ada, Kan., "Poison Ivy" 192 

A. B. Clay, M. D., of Rutherford, Tenn., "Peroxide of Hydrogen in Diphtheria"228 
Henry W. Coe, M. D., of Portland, Ore., "Thiersch's Grafts in Extensive De- 
struction of Soft Parts About Large Joints" 169 

Hermann L. Collyer, M. D., of New York, "Treatment of Vaginitis by Peroxide 
of Hydrogen (Medicinal)," 126 

M. F. Coomes, A. M., M. D., of Louisville, Ky., "Peroxide of Hydrogen as a 
Haemostatic" 225 

Geo. A. Curriden, M. D., of Chambersburg, Pa., "Chronic Gastritis of Long 
Standing, with Periodic Attacks of Migraine" 214 

J. O. DeCourcy, A. M., M. D., of St. Libory, 111., "Diseases of the Alimentary 

Canal; Treatment. Internal and External Hydrotherapy. Medication" 156 

"Treatment of Acute and Chronic Ulcers" 147 

"Malignant Sore Throat and Its Treatment" . . 202 

B. H. Detwiller, M. D.,of Williamsport,Pa., "Letter to the N. Y. State Medical 

Reporter" 199 

W. B. Dewees, M. D., of Salina, Kan., "Medicinal vs. Commercial Peroxide of 
Hydrogen" 102 

J. H. DeWolf, M. D., of Baltimore, Md., "Medicinal Peroxide of Hydrogen and 
Glycozone" 87 

S. Potts Eagleton, M. D., of Philadelphia, Pa., "A Resume of the History and 
Practical Application of Hydrogen Peroxide in Surgical Affections" 84 

Cyrus Edson, M. D., Health Commissioner, Board of Health, N. Y., "The 

Therapeutics of Glycozone, Composition and Characteristics" 12 

"Hydrogen Peroxide in Contagious Diseases — Cholera, Yellow Fever, Typhus, 
Typhoid Fever" 44 

H. Endemann, Ph. D., Chemist, "The Real Value of the Medicinal Peroxide of 
Hydrogen Preparations Found in the Market" 1 

Landon B. Edwards, M. D.,of Richmond, Va., "Vaginal Douche of Hydrozone"223 

Francis T. B. Fest, M. D., of Plank Road, Mich., "Rational Treatment of Per- 
tussis" 1 97 

J. A. Fort, M. D., of Paris, France, "Electrolysis for the Treatment of Strictures"2o8 

Paul Gibier, M. D., of New York, "Peroxide of Hydrogen and Ozone; Their 
Antiseptic Properties" 73 

Egbert H. Grandin, M. D., of New York, "Peroxide of Hydrogen in Gynecology 
and in Obstetrics" 79 

N. H. Haight, M. D., of Oakland, Cal., "Peroxide of Hydrogen as a Local 
Application in Rhus Tox Poisoning" 102 

George B. Hope, M. D., of New York, "Some Clinical Features of Diphtheria 
and the Treatment by Peroxide of Hydrogen" 65 

Frank C. Hoyt, M. D., of Clarinda, la., "Mechanical Feeding in the Insane". .237 

Walter B. Johnson, M. D., of Paterson, N. J., "Peroxide of Hydrogen and Its 
Use in Ear Diseases" IQ 8 

George W. Kaan, M. D., of Boston, Mass., "Peroxide of Hydrogen as a De- 
odorizer in Cancer of the Uterus" I01 

L. D. Kastenbine, A. M., M. D., of Louisville, Ky., "Hydrogen Dioxide — 
H 2 2 " 154 

James S. Kennedy, M. D., of Chambersburg, Pa., "Scarlet Fever" *73 

R. M. Kirley,M. D., Superintendent Female Hospital of St. Louis. "Tubercular 
Adenitis of the Neck" Io8 

Percival Lantz, M D., of Alaska, \V. Va., "Diphtheria; False Membrane Ex- 
pelled ; Recovery" x 44 

John A. Larrabee, M. D", of Louisville, Ky., "Some Practical Points in Thera 
peutics" 9 1 

Elmer Lee, A. M., M. D., of Chicago, 111., "The Treatment of Typhoid Fever" 39 



VII 

"Cholera; Prevention and Treatment" 160 

"Treatment of Asiatic Cholera" 193 

"Syphilis Successfully Treated by Hydriatics" 231 

F.P. Lefferts, M. D., of Belvidere, N. J., "Pelvic Peritonitis with Resulting 

Abscess" t 7S 

H. E. Lewis, M. D., of Burlington, Vt., "The Successful Treatment of Riggs' 

Disease" 1 80 

E. Lawrence Linder. M. D., of Blackfoot, Tex., "Treatment in Diphtheria". .219 

A. Livezey, M. D., of Vardley, Pa., "Peroxide of Hydrogen" 76 

I. N. Love, M. D., of St. Louis, Mo., "Diphtheria, Local Treatment" 97 

"Cholera Infantum" 190 

Thomas H. Manley, M. D., of New York., "Some of the Uses of Peroxide of 

Hydrogen in General Surgery" no 

"Surgical Measures of Relief in Stenosis of the Upper Air Passages" 113 

Discussion on Dr. Manley's paper 116 

Joseph M. Mathews, M. D., of Louisville, Ky., "Abstract from a Treatise on 

Diseases of the Rectum, Anus and Sigmoid Flexure" no 

"The Etiology, Diagnosis and Treatment of Ulceration of the Rectum" 141 

Medical Fortnightly, (editorial,) St. Louis, Mo., "Peroxide of Hydrogen in 

Conjunctivitis" 154 

Robert T. Morris, A. M., M.D., of New York., "The Necessary Peroxide of 

Hydrogen" 72 

"Appendicitis" 117 

W. S. Mullins, M. D., of Henderson, Ky., "Peroxide of Hydrogen in Diseases 

of the Mucous and Serous Membranes" 88 

New York Medical Record, (editorial,) New York, "Medicinal Use of Hydro- 
gen Peroxide" 70 

Charles P. Noble, M. D., of Philadelphia, Pa , "The Peroxide of Hydrogen — 

Its Uses in Abdominal Surgery" 83 

Oliver D. Nostrand, M. D., of Cincinnati, O., "Glycozone in the Treatment of 

Gastric Trouble" 107 

J. P. Parker, Ph. G., M. D., of St. Louis, Mo., "Peroxide of Hydrogen" iv 

Frank S. Parsons, M. D., of Boston, Mass., "A Practical Theory and Treatment 

of Pulmonary Tuberculosis," (abstract) 1 79 

C. E. Perkins, M. D., of Sandusky, O., "Retained Nasal Secretion of Syphilitic 

Rhinitis" 103 

Mark W. Peyser, M. D., of Richmond, Va., "Horse-shoe Fistula Successfully 

Treated with Hydrozone" 223 

A. M. Phelps, M. D., of New York., "The Plaster of Paris, Wood, Aluminum. 

Paper, Leather and Steel Spinal Supports" 181 

"Etiology of the Yarious Deformities of Hip-Joint Disease" 127 

G. W. Pickerill, M. D., of Indianapolis, Ind., "Peroxide of Hydrogen, (Medic- 
inal)" 152 

George H. Pierce, M. D., of Brooklyn, N. Y., "The Peroxide of Hydrogen 

(Medicinal); an Indispensable Wound Sterilizer" 106 

David Phillips, M. D., of New York, "Hydrogen Peroxide in Diphtheria" .... 75 
C. A. Phillips, M. D., of Boston. Mass., "Extract from Paper on 'Adjuvants or 

Aids to Gynaecology — Neither Medical nor Surgical' " S7 

Practice, (editorial), Richmond, Va., "Sinus Treated with Peroxide of Hydrogen" Si 
Clarence C. Rice, M. D.. of New York, "F acture of the Septum Narium — Irri- 
tative Congestion of the Turbinates" 145 

M. F. Richards, M. D., of Toledo, O., "Watery Ulcer," 196 

Phillippe Ricord, M. D., of Newark. N. J., "Peroxide of Hydrogen, for the 

Relief of Bites from Venomous Insects" 7T 

Alexander Rixa, M. D., of New York, "New Therapeutics in Hay Fever". ... 176 



William Roberts, Hospital Steward, U. S. A., of Pittsburgh Barracks, N. Y., 
"The Value of Peroxide of Hydrogen in the Treatment of Chronic Gonorrhoea, 
Illustrated by a Case" ioo 

P. N. Russell, M. D., of Fresno, Cal., "Pathology and Treatment of Indolent 
Ulcers" (abstract) 235 

W. Scheppegrell, A. M., M. D., of New Orleans, La., "The Uses of Peroxide 
of Hydrogen in Diseases of the Nose, Throat and Ear" 224 

L. C. Schutt, M. D , of Toledo, O., "Peroxide of Hydrogen" 112 

S. H. Sherman, M. £>., of Boston, Mass., "Treatment of Diphtheria" 104 

John V. Shoemaker, M. D., of Philadelphia, Pa., "Peroxide of Hydrogen, 
Materia Medica and Therapeutics" 88 

J. Lewis Smith, M. D., of New York, "Recent Investigations Relating to the 
Prevention of Diphtheria and Scarlet Fever" 96 

E. R. Squibb, M. D., of Brooklyn, N. Y , "On the Medicinal Uses of Hydrogen 
Peroxide" 68 

Douglas H. Stewart, M. D., of New York, "A Glance at the Management of 

Capillary Bronchitis in Infants" 186 

John J. Sullivan, M. D., of New York, "Peroxide of Hydrogen in the Treat- 
ment of Gonorrhoea — With Report of a Case" 125 

A. S Tuckler, '92. C. M. C, S. F., of San Francisco, Cal., "Wax in the Ears" 91 

J. N. Upshur, M. D., of Richmond, Va., "A Case of Protracted Labor' 220 

Charles P. Wagar, M. D., of Toledo, Ohio, "The Therapeutics of Specific 

Urethritis" 206 

Wm. F. Waugh, M. D., of Chicago, 111., "Scarlatinal Diphtheria" 82 

Arthur "vyeber, M. D., of New Orleans, La., "Notes on the Treatment cf Diph- 
theria" 18S 

Walter S. Wells, M. D., of New York," Chronic Cervical Endometritis. — 
Osmotic Treatment" 163 

F. H. Wiggin, M. D., of New York, "Peroxide of Hydrogen in Typhoid Fever" 92 

"Intestinal Obstructions. Diagnosis and Treatment" in 

"Notes on the Treatment of Faxal Fistula;" (abstract) 226 

W. C. Wile, A. M., M. D., LL. D , of Danbury, Conn., "Hydrozone" 153 

"Local Treatment of Uterine and Vaginal Diseases" 167 

Robert T. Wilson, M. D , of Baltimore, Md., "Some Notes on the Value of 

Peroxide of Hvdrogen" 97 

S. J. Wimmer,'M. D., and F. S. Parsons, M. D., "Notes on the Value of 

Hvdrozonein Various Diseases (Abstract from The Physician's V^de Mecum)". .197 
C. M. Woodward, Surg-General. M. S. T., of Tecumsch, Mich., Medical De- 
partment of Surgeon-General's Office" 106 

Willard Parker Worster, M. D., of New York, "The Treatment and Cure of 
Chancre with Peroxide of Hydrogen (Medicinal)" 149 



RELATIONS 



OF 



BACTERIA TO DISEASE 



The branch of science named bacteriology was opened to the 
medical profession by the classical researches of Prof. Pasteur in the 
settlement of the question of spontaneous generation, and in his sub- 
sequent studies of the process of fermentation. With the investiga- 
tions of that distinguished French savant began our first positive 
knowledge of the definite relations of bacteria to disease in the ani- 
mal kingdom. 

Prof. Robert Koch, of Berlin, has contributed widely by his 
experiments to the progress in knowledge of etiology of infectious 
and contagious diseases. 

Owing to the methods which he has devised in order to practically 
and easily isolate different species of bacteria, we are now enabled to 
follow the phases of their development in pure cultures under varying 
circumstances. 

Microscopical examinations show that, during the various stages 
of their life, bacteria present different forms and dimensions; but it 
is also demonstrated that one species of bacteria, placed under the 
same' circumstances, always present the same forms, and produce the 
same effects. 

Bacteria belong to the vegetable kingdom; they are vegetable 
cells which can be cultivated in a suitable medium under favorable 
conditions of temperature. The nutrient material must be free from 
pre-existing micro-organisms, called microproteine. 

The pathogenic bacteria only, are of the greatest interest to the 
physician, as they are known to be the cause of infectious diseases in 
human beings, and, according to the definition given by Prof. Koch, 
a micro-organism is pathogenic when it presents the following char- 
acteristics: 



First. — It must be found in the excretions, secretions, or tissues 
of the animal suffering or dead from the disease. 

Second. — The micro-organism must be cultivated out from the 
organism. 

Third. — A pure culture inoculated in an animal should reproduce 
the disease. 

Fourth. — The bacteria should be found in the humors or tissues 
of the animal after death. 

Pathogenic bacteria are differently affected in their infective 
power by the soil in which they grow; some of them have merely a 
local action, while others produce the infection of the whole system 
with prodigious rapidity. 

These facts have been demonstrated from microscopical exam- 
ination; for example, the autopsy shows that the blood of a patient 
who died from diphtheria is invaded with a large number^of Klebs- 
Lcefler bacilli and toxines, the same germs being also present in 
diphtheritic membranes, although the disease was at first a local 
affection. 

The blood of a patient who died from anthrax contained a large 
number of anthracis bacilli, which were at first found only in the 
excretions or pus coming from the infected surface. 

Therefore the contagion is not always immediate, and it is pre- 
vious to the period of incubation, or infection, that the microbian 
element should be either eliminated or destroyed by antiseptic reme- 
dies. 

Micro-organisms (vegetable cells) in the atmosphere have been 
shown by Ehrenburg to exist in masses or clouds; so that, in a room 
containing infection, a portion of the air may be loaded, while other 
portions are free, which would seem to explain cases of escape from 
septic or zymotic influences. 

It is owing to the existence of these micro-organisms, that Profs. 
Pasteur, Koch, Tyndall and other scientists have been able to estab- 
lish the germ theory, and the etiology of diseases. 



DISEASES CAUSED BY GERMS OR MICROBES. 

DISEASES OF THE NOSE, THROAT AND CHEST.— Diphtheria, 
Scarlet Fever, Sore Throat, Quinsy, Tonsillitis, Catarrh of the Nose, 
Ozcena, Hay Fever, La Grippe, Bronchitis, Asthma, Laryngitis, Pharyngitis, 
Whooping Cough, Pneumonia, Consumption, etc. 

DISEASES OF THE GENITO-URINARY ORGANS.— Gonorrhoea, 
Urethritis, Paraphimosis, Chancres (specific or not), etc. Women's Weak- 
nesses: Whites, Leucorrhcea, Vaginitis, Metritis, Endometritis, Ulceration 
of the Uterus, etc. 

INFLAMMATORY AND CONTAGIOUS DISEASES OF THE 
ALIMENTARY CANAL.— Typhoid Fever, Typhus, Cholera, Yellow 
Fever, Cholera Infantum, Dyspepsia, Catarrh of the Stomach or Gastritis, 
Ulcer of the Stomach, Constipation, Diarrhoea, Dysentery, etc. 

OPEN SORES. —Abscesses, Carbuncles, Anthrax, Buboes, Pyaemia, 
Ulcers, Cancerous Sores, Gangrenous Sores, Lupus, Burns, Ulcerated Gums, 
Stomatitis, Rigg's Disease, etc. 

SKIN DISEASES.— Eczema, Psoriasis, Itch, Erysipelas, Poisoning 
Ivy, Acne, etc. 

DISEASES OF THE EYES.— Catarrhal Conjunctivitis or Ophthalmia, 
Purulent Conjunctivitis, Ophthalmia Neonatorum, Blepharitis, Inflamed and 
Granulated Eye Lids, etc. 

DISEASES OF THE BLADDER.— Purulent Cystitis, Catarrhal In- 
flammation, Ulcer, etc. 

It is no wonder after becoming acquainted with such facts as the 
above, that the scientists have studied with care the properties of 
antiseptics, in order to destroy germs. 

Predisposition to Disease. — Although all human beings and 
animals absorb during their life, millions of pathogenic germs (vege- 
table cells) some individuals are more liable than others to be the 
victims of their destructive and infectious action. 

This is due to the fact that the animal cells which constitute our 
body are either strong or weak. 

When they are strong they resist the destructive action of vege- 
table cells (germs) which they either readily destroy or eliminate from 
the system. 



In this case, the composition of our blood is normal, and the 
eliminating power is such, that the microbian element does not 
develop. Hence the individual remains free from disease. 

On the contrary, when the animal cells' vitality has been impaired 
by external influences, the vegetable cells (germs) will accomplish 
their destructive work and develop in the human body with more or 
less rapidity, according to the degree of weakness of the animal cells, 
and the nature of the soil with which they come in contact. 

In such a case the composition of blood is always abnormal, 
some of its constitutive elements being in excess, while others are in 
deficiency. 

Hence, the absorbing power being greater than the eliminating 
power > the microbian element develops, ptomaines may invade the 
whole system, producing infection. 

In fact infection sets in only when the eliminating power of the 
patient is in deficiency, relative to his absorbing power. 

When a human being absorbs a given amount of pathogenic 
germs, the animal cells with which these germs come in contact, must be 
strong enough to either destroy or eliminate all the germs, before they 
reproduce their kind. If nature is powerless to accomplish this, 
antiseptic remedies must be applied in order to annihilate the micro- 
bian element, but it is of the utmost importance that the remedy 
should destroy exclusively the germs and leave the surrounding tis- 
sues in a healthy condition. 

Destructive Action of Ozone upon the Germs and Virus.— 

A fact known by bacteriologists and chemists is: that all virus is albu- 
minoid, whether propagative or not, it is destroyed, or by coagulation 
rendered inert, by the oxidizing action of "Ozone," just as it is by con- 
tact with corrosive sublimate and other antiseptics. 

Then, it is evident that if some substance could be produced 
which would oxidize or destroy these micro-organisms, so as to change 
their infectious character, a great benefit would result, "providing 
this destroyer of germs would have no injurious action upon 
animal cells." 



Such a substance we have in ozone, O s ; or condensed oxygen, 
2 -(-0. It is nature's disinfectant. 

Houzeau found the air of the country at the height of six feet 
above the ground to contain ^oiro o °f * ts weight of ozone, or ^oVo-iS" 
of its volume. 

This very small quantity of ozone is sufficient, owing to its won- 
derful oxidizing power, to destroy germs. 

"Ozone" is a normal constituent of fresh air; its proportion varies 
with temperature and electric conditions of the atmosphere. 

Billard, Wolfe, Boeckel, and Strambes agreed that the cholera, 
when it raged in Strasbourg, Berlin and Milan, coincided with the 
absence of ozone in the atmosphere, and that ozone reappeared at the 
end of the epidemy. 

These observations are in perfect accord with those obtained by 
Dr. F. H. Hammond. Dr. Moffatt, Romain Vigouroux, Uhle, and 
other scientists also attribute the prevalence at time of cholera, 
malarious fever, to the absence of ozone in the air. 

Is it due to an excessive production of miasms relatively to the 
normal proportion of ozone, or is it because "Ozone" is in deficiency 
to destroy these germs ? 

No one could answer this question, but a positive fact is that: 
"If Ozone is in excess, there is no epidemy." 

The wonderful antiseptic value of "Ozone" has attracted the 
attention of all scientists, and a number of chemists have devised 
different methods of its production; but none of these processes 
could be used to manufacture ozone industrially. 

Hydrozone (30 volumes solution Peroxide of Hydrogen) is always 
on a strain to break up into water and nascent oxygen near to the 
condition of ozone. 

The following synopsis shows the similarity which exists between 
the oxidizing power of both Hydrozone and ozone. 



COMPARATIVE CHEMICAL REACTIONS BETWEEN 
HYDROZONE AND OZONE. 



1 

Iodide of Potassium So- I 

lution in presence of 



Permanganate of Potash 
Purple Solution in pres- 
ence of ' 



H 3 3 30 vol. Sol. 
(Hydrozone.) 

Ozone. 

H 2 2 30 vol. Acid- 
ulated Solution 
(Hydrozone.) 



~( ~ „*:~ i Potash and Iodine, 
of reaction / 



Result 
of reaction 



Potash and Iodine. 



Result 
of reaction 



Peroxide of Iron Salt So- 
lution and Ferricya- 
nide of Potassium So- 
lution mixed together 
in presence of 



K 2 Mn 8 8 + 4 H 8 O s 
Ozone. 



Immediate discoloration. 

Escaping of Oxygen 

Gas and formation of 

brown Oxide of Man- 

(_ ganese. 

2 KHO-f Mn 2 H 6 6 -j-4 O, 



Tincture of Indigo in 
Presence of 



Nitrous Acid in presence 
of 



Arsenious Acid in pres- 
ence of 

Tincture of Guaiacum 
mixed with either 
Blood or Extract of )- 
Malt. 

Organic substances such ' 
as Cotton, Woolen, 
Silk, Feathers, Hair, 
Bones, Ivory, etc., in 
presence of 



H 3 2 30 vol. Sol. 
(Hydrozone.) 

Ozone. 

H 2 3 30 vol. Sol. 
(Hydrozone.) 

Ozone, 

H 2 2 30 vol. Sol. 
(Hydrozone.) 

Ozone. 

H 2 2 30. vol Sol. 
(Hydrozone.) 

Ozone. 

H 2 2 30 vol. Sol. 
(Hydrozone.) 

Ozone. 

H 2 2 30 volume 
Alkaline Sol. 
(Hydrozone.) 

Ozone. 



Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 

Result 
of reaction 



Ferricyanide is trans- 
formed into Ferrocya- 
nide of Potassium, giv- 
ing a blue coloration. 

Same result. 
Decoloration. 
Decoloration. 
Formation of Nitric Acid. 

Same result. 

Formation of Arsenic 
Acid. 



Same Result. 

Blue coloration, with ef- 
fervescence and coagu- 
lation of albumen. 

Same reaction. 

Oxidizing and Bleaching 
) Action. 

( Same result but slower 
( Action. 



IMPORTANT INFORMATION ON PEROXIDE OF HYDROGEN 
AND HYDROZONE. 

Anhydrous Peroxide of Hydrogen formula H 2 2 is a syrupy liquid 
which contains 475 times its volume of oxygen, Density 1.452. 

It is a very unstable compound, slightly acid to the litmus paper. 
Its decomposition into water and nascent oxygen takes place under the 
most enigmatical circumstances, hence it is not an article of commerce. 



According to the U. S. Pharmacopoeia, a 3 percent, aqueous solu- 
tion of Peroxide of Hydrogen yields about 10 times its own volume of 
oxygen. (Careful practitioners know that in many cases such a weak 
solution of H 2 2 is powerless to destroy germs, and on that account 
they discarded its use.) 

Charles Marchand's Peroxide of Hydrogen (Medicinal) yields 15 
times its own volume of nascent oxygen, which corresponds to a 4.5 
per cent, aqueous solution, of pure H 3 O s . 

Hydrozone yields 30 times its own volume of nascent oxygen, 
corresponding therefore to a 9 percent, aqueous solution of pure H 2 2 . 
It is a preserved solution which retains its strength for any length of 
time, when kept at a temperature not exceeding 70 F. 

Both Hydrozone and my medicinal Peroxide of Hydrogen are 
slightly acid in taste. 

Hydrozone is not only twice the strength of my medicinal Peroxide, 
but it is far superior as a healing agent. 

In no instance should Hydrozone be made either alkaline or 
neutral before using, even when it is applied to the most delicate 
diseased mucous membranes. 

Bacteriological experiments made upon cultures of pathogenic germs 
have demonstrated that: 

One cubic centimetre of Hydrozone which contains traces of acid, is 
equivalent for its bactericide power to: 

Two cubic centimetres of the same preparation after it has been made 
neutral by the addition of either lime water, bicarbonate of Soda, Ammonia, 
etc. 

And to three cubic centimetres of the same preparation after it has been 
made slightly alkaline by the addition of a small excess of alkali. 

Hydrozone is a harmless remedy, uniform in strength, purity and 
stability; being kept in a cool place, such as a cool cellar, it retains 
its germicide power for any length of time. 

My medicinal Peroxide of Hydrogen freezes at 8° to io° F. 
Hydrozone freezes at about 5 F. When such is the case thaw them 
out slowly at a temperature not exceeding 65 ° to 70 F., so as to pre- 
vent deterioration. 

Action of Hydrozone (30 vol. aqueous solution of H 2 2 ) upon 
Animal Cells and Vegetable Cells.— See report by Dr. Paul 
Gibier, Page 73; also report by Dr. S. Potts Eagleton, page 84. 

Experiments made by Bacteriologists prove beyond doubt that: 

1st. Hydrozone has no injurious effects upon animal cells. 

2d. It has a very energetic destructive action upon vegetable 
cells — microbes. 



8 

3d. It has no toxic properties; five cubic centimetres injected 
beneath the skin of a guinea-pig do not produce any serious result, 
and it is also harmless when administered internally. 

4th. It is a stimulant to granulating tissue. 

5th. It has no corrosive action whatever upon the healthy mucous 
membranes when applied to the treatment of diseases caused by germs, 
such as Diphtheria, Scarlet Fever, Whooping Cough, etc. 

6th. It is the pus destroyer "par excellence." See article headed 
"The Necessary Peroxide of Hydrogen," by Dr. Robert T. Morris, 
page 72. 

Note. — Although Peroxide of Hydrogen as well as Hydrozone 
has no toxic properties, it should never be injected into the cir- 
culation of the blood, on account of its chemical action upon the 
albumen. Two cubic centimetres of Peroxide of Hydrogen (or 
one cubic centimetre of Hydrozone) being injected into the femoral 
vein of a dog kills the animal almost instantly, when the free 
egress of Oxygen gas which is generated in the circulation, is 
prevented by external pressure of the vein. 

Action of Hydrozone upon Open Diseased Surfaces.— 
When Hydrozone is brought into contact with any open diseased sur- 
face, either of the skin or of the mucous membranes, its decomposi- 
tion takes place immediately; nascent oxygen (near to the condition 
of ozone) is set free, the albuminoid element of the unhealthy secre- 
tions is coagulated, pus corpuscles are destroyed and the pus process 
is checked, the Bacteria as well as their spores being annihilated. 

Nascent oxygen oxidizes and cleanses the infected surface and it 
is readily transformed into ordinary oxygen. 

It is of great importance to notice that water charged with fifteen 
times or even thirty times its own volume of oxygen gas (formula O) 
under pressure, has no similar action whatever on the albuminoid 
substances, as there is no coagulation, and no cleansing effect upon 
the unhealthy secretions of any open diseased surface. In fact, it 
does not destroy pathogenic germs. 

This remark plainly establishes the difference between the thera- 
peutical value of Hydrozone and the Oxygen or so-called "Compound 
Oxygen treatment."* 

♦Concerning the so-called "Compound Oxygen treatment," I shall refer the profession to a very 
elaborate report on: 

"The Management of Pulmonary Diseases," by Karl von Ruck, B. S., M. D., Director of the 
Winyah Sanitarium for Diseases of the Throat and Lungs, Asheville, N. C, 1889. On pages 8 and 9 
of this publication, the author writes as follows: 



Hydrozone is recognized by leading physicians (see the opinion 
of the medical profession on pages 65 and 238,) as being the most 
powerful and reliable bactericide known. I now submit to the pro- 
fession the results of comparative tests which I have made, in order 
to demonstrate experimentally the respective bactericide potency of 
the following chemicals: 

■QUANTITY OF THE MIXTURE OR 3% SOLUTION OF THE FOLLOWING 

CHEMICALS REQUIRED TO ANNIHILATE THE SAME GIVEN AMOUNT 

OF KLEBS-LCEFLER BACILLI. 

Cubic Centimetres. 

Hydrozone (harmless) 30 volumes aqueous solution of H 2 8 1. 00 

Biniodide of mercury 1.00 

Biniodideof silver 1.33 

Marchand's Peroxide of Hydrogen, medicinal (harmless) 

15 volumes aqueous solution of H 3 2 2.00 

Bichloride of mercury 3.00 

Nitrate of silver 5 .00 

Hypochlorite of soda 9.00 

Chlorine gas (aqueous solution) .. 10.00 

Iodine 10.00 

Bromine 24.00 

Iodoform (when fresh) 28.00 

Salicylic acid .... 40.00 

Muriatic acid 100.00 

Carbolic acid 128.00 

Permanganate of potash 140.00 

Chlorate of potash 158.00 

Alum 180.00 

Tannin .... 190.00 

Common salt 196.00 

Sulphide of calcium. 201.00 

Boracic acid 300.00 

Sulphurous acid 325 .00 

Lactic acid 360.00 

Perchloride of iron 371.00 

"Inhalation of O xygen. — Undoubtedly some benefit has been derived from such inhalations in 
anaemia and digestive derangements, also in certain forms of dyspnoea I have seen patients made much 
more comfortable after each inhalation, especially when a small quantity of nitrous oxide was added. 
I have also seen an occasional but undoubted increase in the number of red blood-corpuscles under its 
administration, both in essential and symptomatic anaemia, especially when iron preparations, which 
alone had proved inefficacious, could be administered at the same time. Its range of usefulness in con- 
sumption is secondary altogether to many other means, and it is only occasionally that anything more 
than temporary relief can thereby be given, and, no matter how plausible the theory as to its influence 
upon nutrition, practical experience shows that its use is always experimental, and frequently without 
result, the same as is the case in its employment in other diseases. Its mixture with nitrous oxide in 
the form ofthe so-called 'compound oxygen,' by thetemporary stimulating or intoxicating effect of the 
laughing gas, has no advantage whatever, except in dyspnoea, but it makes the patients who become 
the victims of charlatans feel that 'something powerful' is present in such inhalations, and induces 
them to believe in it more readily. This 'compound oxygen cure for consumption ' still flourishes 
in many localities, the same as do the quack remedies for the same object upon the shelves and coun- 
ters of our druggists, and I have no doubt the venders of such with their advertisements are as injuri- 
ous parasites upon the consumptives as are the tubercle bacilli themselves; and while we must ac- 
knowledge that our efforts in phthiso-therapy against the latter have thus far been unavailing, many 
lives could undoubtedly be saved if the former could be extinguished by the enactment of wise laws 
which would oblige them to derive their means of livelihood otherwise than by trifling with human 
life. ' _ 



IO 

Permanganate of potash, hypochlorite of soda, bichloride of 
mercury, the aqueous solution of chlorine gas, carbolic acid, nitrate 
of silver, etc., destroy microbes, but, being toxic, corrosive and 
poisonous, they have the most dangerous effect upon the patient's life. 

It is worthy of note that Hydrozone is absolutely harmless. All 
other powerful antiseptics have toxicant, corrosive, caustic and poison- 
ous properties, as it is proved by chemical and clinical tests; and their 
use is, in most all cases, more dangerous than the disease itself, 
since they destroy both the. vegetable cells (germs) and the surround- 
ing healthy animal cells. 

The comparative tests published on page 9, show that Hydro- 
zone is twice as strong as Marchand's Peroxide of Hydrogen (medic- 
inal), three times as powerful as bichloride of mercury, 5 times as 
powerful as nitrate of silver, 10 times as powerful as iodine, 28 times 
as powerful as iodoform, 40 times as powerful as salicylic acid, 128 
times as powerful as carbolic acid.* 

* The Dangers of Carbolic Acid. — The following experiments which I have made 
prove beyond doubt the dangers of using carbolic acid in the treatment of suppura- 
tive diseases. 

Six dogs were submitted to the action of this corrosive antiseptic in the following 
manner: 

Two or three square inches of hair on the leg of each animal upon which the 
experimentation took place, were closely shaved. 

Morning and evening an application, from 8 to 10 drops (three per cent, solution) 
of carbolic acid was made upon these prepared surfaces and continued for ten days. 

One hour or so after each application the surface was dry, owing to the evaporation 
of water and then, as an immediate consequence it was covered by a small quantity of 
pure, concentrated carbolic acid, of which the corrosive properties are well known. 

At the expiration of said time two of these dogs were sick, each one having an 
ulcer on the prepared surface of the leg, which was due to the repeated application and 
evaporation of the three per cent, solution of carbolic acid; and three days later each 
one of the four other dogs had an ulcer of the same nature, which was produced 
from the same cause. 

These four dogs having been submitted to Peroxide of Hydrogen treatment, were 
cured in four weeks. 

The application of the three per cent, solution of carbolic acid on the ulcers of the 
two other dogs was again continued, and on the fiftieth and sixty-second days, respect- 
ively, both animals expired from blood-poisoning. The autopsy showed that the blood 
of these animals was invaded by the bacteria of Davaine, which was detected from a 
microscopical examination. 



II 

GLYCOZONE. 

IMPORTANT INFORMATION. 

Glycozone is a stable compound resulting from the chemical 
reaction which takes place when c. p. glycerine is submitted under 
special conditions, to the action of fifteen times its own volume of 
ozone, under normal atmospheric pressure at a temperature of 0° C. 
Its density is 1260 grammes. 

The presence of water (and other foreign substances) in the 
glycerine, changes the nature of this reaction, so that instead of pro- 
ducing glycozone, we obtain formic acid, and other secondary products 
having deleterious effects upon animal cells. 

Glycozone being hydroscopic, must be tightly corked, so as to 
avoid being deteriorated by the moisture contained in the atmosphere. 

Although Glycozone absorbs water readily, it does not deterio- 
rate when kept at a temperature below no degrees F. As long as it 
retains its proper anhydrous condition, its healing properties increase 
with age. 

The therapeutic properties of Glycozone and Hydrozone, differ 
in the following particulars: 

Hydrozone instantly destroys the morbid element of diseased 
surfaces of the skin or of the mucous membrane with which it comes 
in contact, leaving the tissues beneath in a healthy condition. 

Glycozone acts more slowly, but not less certain as a stimulant 
to healthy granulations. Its healing action upon diseased mucous 
membrane is powerful and harmless in the treatment of inflammatory 
diseases of the stomach. In such cases it gives an immediate relief 
to the patient. 

Glycozone has a pleasant, sweet and acidulated taste. 

Caution. — Glycozone is a peculiar chemical compound, and not 
a mixture of Peroxide of Hydrogen (medicinal) with glycerine. 

These two liquids when mixed do not form a stable product, but 
develop substances which have injurious effects upon animal cells. 

Such a mixture when freshly made has no healing properties 
similar to Glycozone. On the contrary, Glycozone is stable, harmless 
and always effective. 



12 

THE THERAPEUTICS OF GLYCOZONE. 
COMPOSITION AND CHARACTERISTICS. 

By CYRUS EDSON, M. D., 

Formerly Health Commissioner, Board of Health, New York City. 

(Published by the Times and Register, Philadelphia, Pa., April 22, 1893.) 

Glycozone is defined by its discoverer, Mr. Ch. Marchand, to be 
a stable compound, resulting from the chemical reaction that takes 
place when c. p. glycerine is submitted, under certain conditions, to 
the action of fifteen times its own volume of ozone, under normal 
atmospheric pressure at 0°C. 

The necessity of using c. p. glycerine is imperative, as the pres- 
ence of water or other foreign matter in glycerine causes the produc- 
tion in the resulting compound of formic acid, glyceric acid, and other 
secondary products, that have a harmful effect upon animal tissues. 

Glycozone has a pleasant, sweetish taste. Being hydroscopic, it 
must be kept in tightly corked bottles, and as long as it is kept in 
this condition, it does not deteriorate at a temperature of even no 
degrees F. 

Antagonists and Incompatibles. — Glycozone, like Peroxide 
of Hydrogen, is a powerful oxidizing agent, although its action is not 
as rapid or as energetic in this respect as the latter compound. Con- 
sequently we cannot safely prescribe it combined with any other 
drugs or chemical substances. Contact with metallic utensils decom- 
pose it. We must therefore use glass or hard rubber vessels and 
syringes when administering it. 

Physiological Action. — When taken into the mouth and 
stomach, Glycozone causes a feeling of warmth. It excites a flow 
of saliva and stimulates the gastric secretions. Being hydroscopic it 
attracts to itself water from the surrounding tissues, but not with 
sufficient power to effect harm. In very large doses one or two 
ounces, it causes a feeling of distress in the epigastrium and is fol- 
lowed by loose, copious, watery stools, which are accompanied by 
severe cramps. 

No effect is noted on the kidneys, the liver or the heart. Gly- 
cozone is undoubtedly slowly decomposed in the stomach, ozone being 
liberated and the glycerine uniting with the water from the tissues. 



The morbid elements with which it comes in contact probably hasten 
this decomposition, and in so doing are themselves oxidized and 
destroyed. The free ozone in the stomach resulting from the decom- 
position of glycozone aids the digestive process by its presence. 

Therapy. — Glycozone is, in the opinion of the writer, the best 
known agent for the treatment of gastric ulcer. It is also one of the 
best remedies for the treatment of the stomach, catarrh or chronic 
alcoholism, and for chronic gastric catarrh from other causes. It is 
excellent for atonic dyspepsia, and for acid dyspepsia. The writer 
has seen very gratifying results from its use in these distressing 
maladies. 

In catarrh and other stomachic diseases except gastric ulcer, 
the remedy is best administered in one or two teaspoonfuls in a 
wineglassful of water immediately after meals. In the case of gastric 
ulcer the dose and dilution should be the. same, but it is better to 
give it when the stomach is empty, an hour or so before meals. 

Glycozone has an excellent effect when used internally in cases 
of diphtheria. For this purpose a tablespoonful of glycozone is given 
in a wineglassful of water every three hours. As it is perfectly harm- 
less it may be used without apprehension. 

The following treatment is excellent in cases of membranous 
croup: The nose, throat, mouth, pharynx, and larynx should be 
sprayed copiously every two hours or so with a mixture of one ounce 
of Marchand's Peroxide of Hydrogen (medicinal),* with four to six 
ounces of water. 

The membranes are readily destroyed, and by using this remedy 
freely, their reproduction is prevented. Then one teaspoonful of 
glycozone diluted in a wineglassful of water administered three times 
a day, prevents any disturbance of the stomach and regulates the 
bowels. 

Remarkable benefit may be derived in the treatment of diseased 
conditions (ulcerations and chronic inflammation) of the rectum and 
lower gut, by enemata containing glycozone, and for this purpose 
nothing excels the following formula: 
i ounce of Glycozone 
12 ounces of lukewarm water. 



♦Better results will be obtained if Hydrozone is used instead of Peroxide of Hydrogen (medicinal.) 



14 

Is 

This should be mixed immediately before using and administered 
with a hard rubber syringe" once daily. It is frequently desirable to 
use a smaller amount than the above mixture. The proportions i to 
12, however, should be maintained. In cases of fistula-in-ano and of 
rectal ulcerations low down, an ounce of lukewarm water containing 
a drachm of Glycozone administered once or twice daily, soon effects 
good, and in cases of ulcer, pure and simple, may be expected to radi- 
cally cure the diseased conditions. 

External Uses. — After the cleansing of any diseased or sup- 
purating surface by Peroxide of Hydrogen (medicinal), the application 
of Glycozone stimulates healthy action and hastens the cure. For 
this purpose it has no superior in the entire range of Therapeutics. It 
tends to check the discharge of irritating unwholesome secretions 
and to prevent the infection of the sore by pathogenic organisms. Its 
action in this respect is explained by the fact that it is both power- 
fully antiseptic and stimulant. 

Follicular Pharyngitis, chronic coryza, and ulcerated stomatitis 
are all benefited by frequent applications of Glycozone. As an appli- 
cation to ulcerated cervix-uteri and in tumefied conditions of the cer- 
vix and uteri it is far superior to pure glycerine. 

In these cases, and for the cure of leucorrhcea, the remedy should 
be applied on small rolls of lint, or absorbent cotton, the vagina 
having first been thoroughly washed with an injection of Peroxide of 
Hydrogen one part,* water four parts. This procedure should be 
repeated twice daily. 



♦When Hydrozone is substituted to Peroxide, one part of Hydrozone with eight parts of water 
is strong enough and better results will be obtained. 



•5 



GENERAL DIRECTIONS FOR USING AND APPLYING 

HYDROZONE AND GLYCOZONE 

BOTH INTERNALLY AND EXTERNALLY 

THE IN TREATMENT OF DISEASES CAUSED BY GERMS. 



NOSE.— THROAT AND CHEST DISEASES.— TREATMENT. 

CA TARRH OF THE NOSE AND CA TARRH OF THE THRO A T. 

Causes.— Micro-organisms, principally of the micrococcus species 
have been detected by microscopical examinations, in the mucous dis- 
charges from the nostrils of persons afflicted with this disease. Those 
germs which cause the infection are readily destroyed by Hydrozone 
and there is no danger for the patient to use this remedy in any 
quantity as it is positively harmless. 

Treatment. — By means of an atomizer made of glass and hard 
rubber, spray the nose and the throat copiously and repeatedly twice 
or three times every day with a mixture of: 
i tablespoonful of Hydrozone 
with 8 to 20 tablespoonfuls of water (lukewarm,) 
taking great care that the remedy should always pass through the 
post-nasal tubes and reach the throat. Dilute Hydrozone with luke- 
warm water, according to the degree of sensitiveness of the patient. 
Some patients may stand a mixture of one part Hydrozone to four 
parts of water while others cannot stand more than one part of 
Hydrozone to thirty parts of lukewarm water. 

In the absence of an atomizer, apply the remedy to the nose by 
sniffing the liquid from the hand through the nostrils repeatedly and 
gargle the throat. It is always beneficial to swallow the remedy. 

Do not blow the nose too hard, as it might cause a temporary 
bleeding, and remain indoors for fifteen minutes after spraying the 
nostrils. 

In chronic cases of long standing, (injurious drugs having been 
used) especially at the beginning of the treatment, when the tender- 
ness of the mucous membrane is excessive, it often happens that the 
patient will feel during one hour or so after each spraying of the nose, 
a partial obstruction of either one or the other of the nostrils. 



i6 

This rather unpleasant feeling is often accompanied by frequent 
sneezing, which is due to the tickling sensation produced in the nasal 
cavities by the presence of a great quantity of minute bubbles of 
"Ozone," being set free from the decomposition of Hydrozone com- 
ing in contact with the infected surface. The unhealthy secretions 
are destroyed by "Ozone," and the cleansing of the nostrils is made 
perfect. 

In chronic cases, when the middle ear is involved, deafness may 
be the consequence of this disease. Then ozonized vapor inhal- 
ations should follow immediately the spraying of the nose and the 
throat, and should be administered by means of Charles Marchand's 
Hand Atomizer and Ozonizer, with a mixture thoroughly made of: 

i tablespoonful of Hydrozone 

i " of water 

2 " of pure glycerine. 

In many cases better results will be obtained by using a mixture 
made of equal quantities of Hydrozone and glycerine. 

Shake well and renew the mixture every three days. The above 
mixture must be made perfect, otherwise the spray-tube of the appa- 
ratus might clog on account of the syrupy nature of the glycerine. 

A permanent cure may be accomplished in a very short time. 

When chronic catarrh of the nose is very tenacious and painful, 
it is necessary at night before retiring, to apply a few drops of Gly- 
cozone to the nostrils by means of a soft camel's hair brush. Sniff it 
gently, it will accelerate the cure. 

In many cases the incurability of chronic catarrh of the nose may 
be due to partial or even complete obstruction of the nasal cavities, 
caused by some abnormal growth. 

When such is the case, apply Hydrozone, as heretofore explained, 
morning and evening. After ten or fifteen days, if the excrescence 
does not disappear, it may be necessary to have a surgical operation 
performed for its removal. 

After the excrescence has been removed or destroyed by means 
of the thermocautery, or otherwise (no caustic should be used, as it 
will most likely destroy both taste and smelt), an absolute cure is certain 
if the above treatment is earnestly followed. 



i7 

The profession well know that the remedies usually prescribed 
for the treatment of this disease are as follows: 

Bichloride of Mercury. — Calomel. — Sulphate of Zinc. — Sulphate of Cop- 
per. — Alum. — Nitrate of Silver. — Carbolic Acid. — Salicylic Acid. — Perman- 
ganate of Potash. — Borax. — Boracic Acid. — Subnitrate of Bismuth. — Com- 
mon Salt. — Muriate of Ammonia. — Extract of Eucalyptus. — Thymol. — Men- 
thol. — Cocaine. — Camphor, etc. 

In all cases strong antiseptics destroy germs, but at the same time 
they weaken and frequently destroy the life of animal cells. 

Therefore it is easily understood why Hydrozone will surely give 
prompt relief and accomplish a permanent cure, while the above named 
remedies are apt to either injure or destroy both taste and smell. 

In fact, even if a patient has used injurious antiseptics for a long 
time, the Hydrozone treatment will always give immediate relief, but 
before a cure can be accomplished, the animal cells having to be 
restored to their normal condition, it may require more or less time. 
Hydrozone will accomplish this for the following reasons: 

First. — Because it is the most powerful of all antiseptics yet dis- 
covered. 

Second. — It is not only harmless to healthy tissues, but it restores 
and stimulates the life of animal cells, which have been more or less 
seriously affected. 

Third. — Borax, boracic acid, subnitrate of bismuth, muriate of 
ammonia, common salt, camphor, thymol, are not dangerous 
remedies, but they are powerless to destroy the germs which cause 
the disease, having no stimulating action whatever upon diseased 
tissues. 

On the contrary, Hydrozone annihilates the germs instantane- 
ously, and it leaves the surrounding tissues in the most healthy con- 
dition. 

Note. — In case of excessive tenderness of the mucous membrane 
of the nostrils, spraying the nose with a cold mixture of Hydrozone 
with water, may cause a severe pain for a few moments. 

In order to allay this pain the remedy should be used mixed 
with lukewarm water instead of cold water, or better still, prepare the 
mixture with cold water and warm it before using. 



i8 

Dr. Robert T. Morris recommends the use of a 3 per cent, solu- 
tion of cocaine before spraying the nostrils with diluted Peroxide of 
Hydrogen (medicinal) or Hydrozone in order to quiet the smarting 
sensation. (See page 72). See also pp. 145, — 176,-- — 207, — 212, — 
224. 

OZ^ENA, OR PUTRID CATARRH OF THE NOSE. 

Ozaena is frequently the consequence of catarrh having been 
treated for a long time by means of injurious remedies. It is very 
offensive and tenacious, and must be treated as follows: 

Spray copiously the nostrils and the throat, morning and evening 
with a mixture made of: 

1 tablespoonful of Hydrozone 

with 6 to 10 tablespoonfuls of water (lukewarm). 

It is only in case of extreme tenderness of the mucous membrane 
that a weaker solution should be used as follows: 
1 tablespoonful of Hydrozone 
with 12 to 20 tablespoonfuls of water (lukewarm). 

In the absence of an atomizer, apply the remedy to the nose by 
sniffing the liquid from the hand through the nostrils repeatedly, and 
gargle the throat. The remedy should always pass through the post 
nasal cavities. 

Hydrozone full strength may be applied to each nostril equally 
as well by means of a camel's hair brush, free from metallic parts. 

This treatment is so powerful, that the destruction of the micro- 
bian element takes place immediately, and the offensive odor which 
characterizes this peculiar and repulsive affection is removed three or 
four days after the beginning of application. 

The cure may be accomplished in two months, but in some 
instances, when the case is of a very long standing it requires more 
time to effect an absolute cure. 

In all cases of ozaena, by means of a camel's hair brush, apply 
Glycozone to the nostrils, morning and evening, after spraying, sniff 
it gently. It will accelerate the cure. 

In cases of sneezing and obstruction of the nostrils after each ap- 
plication of the remedy, see the explanations given, page 16, article 
headed "Catarrh of the Nose." 



19 



HAY FEVER.— ROSE COLD.— CORYZA. 

Causes. — The microscopical examination of the unhealthy mu- 
cous secretions and excretions from the nostrils of Hay- fever suffer- 
ers demonstrated the presence of small ovoid micro-organisms, which 
are annihilated instantly when brought into contact with Hydrozone. 

It is worthy of notice that the degree of susceptibility to the in- 
fectious action of these germs or microbes differs with different 
people. The spores and germs which cause this disease do not 
always find a proper medium for development in the mucous secre- 
tions of different people. 

The peculiarity of this disease is, that anyone who is afflicted with 
Hay Fever can foretell every year, almost to a certainty, the day up- 
on which it will begin, and also the day upon which they will get 
rid of it. 

The logical explanation of this is, that the conditions of life of 
Hay Fever sufferers are always the same; "that is, the circumstances 
and surroundings of their existence are absolutely alike from year to 
year." Thus the microbial! causes of the trouble develop under the 
same influences every year, at about the same time and, consequently 
the disease begins when the atmospheric conditions become favorable 
for the development of the spores I have mentioned. These spores 
grow, under proper conditions of temperature and dampness, in the 
mucous secretions of the nostrils, the microbian infection takes place, 
producing inflammation and ulceration of the mucous membrane. 

These micro-organisms continue their growth as long as these 
favorable atmospheric conditions exist, and they disappear as soon as 
the temperature falls and while it remains at a lower degree. Then 
the effects disappear with their causes, and the patient gets rid of his 
trouble. 

Treatment. The causes of Hay Fever being now well estab- 
lished, it is easy to understand that any remedy having the property 
to destroy microbes or germs will surely cure, or at least prevent the 
disease by removing the cause, providing this remedy will have no 
injurious effects upon the surrounding healthy tissues. 

In case of Hay Fever, Hydrozone should be applied locally to the 
nostrils as a spray, and also by inhalations of ozonized vapor in order 



20 

to subdue the asthmatic attacks which accompany this very trouble- 
some complaint. 

It has been demonstrated that among the list of antiseptic reme- 
dies published on page 9, Hydrozone is the most powerful, and at 
the same time, harmless bactericide. 

I have explained on page 8, that : When Hydrozone comes in con- 
tact with any open infected surface, either of the skin or the mucous 
membrane, ozone is set free, the microbes are instantly destroyed as 
well as the unhealthy secretions in which they develop and the dis- 
eased surface is then cleansed and made aseptic. The residue of this 
reaction is water and coagulated albumen. 

In fact, the Hydrozone treatment is based upon the indisputable 
results which are obtained when a Hay Fever patient goes to the 
White Mountains, where the atmospheric conditions are such that the 
air contains always a small quantity of ozone. The constant breath- 
ing of this ozonized atmosphere accomplishes the cure, or at least 
relieves this disease in a very short time. 

Hay Fever will always be prevented by an early application of 
Hydrozone, (two weeks before the disease is expected), in those cases 
which occur regularly at known periods of the summer. 

When the disease has developed, the same treatment will check 
it within three or four days, the patient being comfortable, but he 
shall never be entirely free from his trouble. In all cases it is urgent 
to continue the treatment during the whole Hay Fever season, other- 
wise the sufferer will surely be troubled, even if he stops the treat- 
ment for only 24 hours. 

The remedy should be applied as follows: 

First. — Spray the nostrils and throat copiously and repeatedly 
twice or three times every day with a mixture of: 
1 tablespoonful of Hydrozone 
with 8 to 30 tablespoonfuls of water (lukewarm), 
according to the degree of inflammation. 

Some patients may use the remedy diluted in the proportion of 1 
to 4, without discomfort, while others could not use it, except if it is 
diluted with lukewarm water in the proportion of 1 to 30. The pro- 
portion in which the mixture should be made must be regulated, 
according to the degree of tenderness. 



21 

Second. — By means of Charles Marchand's Hand Atomizer and 
Ozonizer, inhalations of ozonized vapor should be administered with 
a mixture thoroughly made of: 

i tablespoonful of Hydrozone 

i " of water 

2 " of pure glycerine. 

The above mixture should be thoroughly made and renewed 
every three days. 

(See description and cuts of Charles Marchand's Hand Atomizer 
and Ozonizer, pages 32 and 33.) 

The duration of each inhalation should not exceed ten minutes, 
and should be taken three to six times daily. Inspirations should be 
as deep and prolonged as possible. % 

Note that I claim to prevent Hay Fever, but I don't claim to cure 
it. Therefore Hay Fever sufferers must follow the treatment every 
year, beginning at least two weeks before they know that they will 
have the first attack. In this way the animal cells of the mucous 
membrane of the nostrils will be rendered strong enough to resist 
the infection of the germs which will be either eliminated or destroyed 
at the time they make their appearance. 

When a Hay Fever patient has been fortunate enough to use only 
harmless remedies to relieve his trouble, he will find an immediate 
relief, by following the above treatment. If he has used strong drugs 
which have injured the animal cells, it may require one week or ten 
days, before he feels relieved. 

In most all cases a few drops of Glycozone being applied to each 
nostril morning and evening helps to quickly relieve the patient. 
Sniff it gently and repeatedly. 

The Hydrozone vapor inhalations relieve the patient from asthma, 
which often accompanies this troublesome affection. 

INFLUENZA.— LA GRIPPE. 

Causes. — This disease is caused by microbes of a special kind 
which act upon both the respiratory organs and the nervous system. 

The local symptoms of this infectious disease are a severe naso- 
pharyngeal catarrh with headache, sore throat and bronchitis. 

The general symptoms are a feeling of lassitude, with acute pains 
in the limbs and back, accompanied with fever and profuse perspira- 
tion. 



The internal treatment which may be prescribed by the physician 
with an appropriate diet will soon relieve the patient from the general 
symptoms, but, the danger is due to complications which either accom- 
pany or follow the influenza, such as laryngitis, bronchitis, acute lobar 
pneumonia and pleurisy. 

In fact, the local symptoms, viz.: The inflammatory condition of 
the respiratory tract must be promptly subdued in order to prevent 
the microbian infection from producing dangerous complications. 

Owing to the destructive action upon the germs which are the 
cause of influenza, Hydrozone will always subdue the inflammatory 
condition of the respiratory organs. 

Treatment of the Local Symptoms. — First. — Spray the nos- 
trils copiously and repeatedly every three hours with a mixture 
made of: 

i tablespoonful of Hydrozone, 
with 8 to 10 tablespoonfuls of lukewarm water, 
according to the sensitiveness of the mucous membrane. 

Second. — In order to reach the seat of the disease, deeply located 
in the bronichal tubes, by means of the hand Atomizer and Ozonizer 
(see pages 32 and 33)inhalations of ozonized vapor must be adminis- 
tered three to six times every day with a mixture thoroughly made 
of: 

1 tablespoonful of Hydrozone, 
1 " of pure glycerine. 

Shake well and renew this mixture every three days. 

The above described treatment will not only check the local symp- 
toms, but it will also prevent the patient from being subsequently 
troubled with chronic bronchitis. 

Treatment of Asthma. — By means of Ch. Marchand's Hand 
Atomizer and Ozonizer, inhalations of ozonized vapor should be ad- 
ministered three to six times daily. Any similar apparatus made of 
metal should never be used in connection with Hydrozone. 

The action of Hydrozone vapor, upon the diseased surface of 
the bronchial tubes or the cells of the lungs is similar to the action 
of this bactericide upon any open sore or ulcer which is invaded by 
microbes. The microbian element is destroyed at the contact of 
ozone, which is set free, and the diseased tissues are disinfected and 



23 

made healthy. The bronchial trouble is easily relieved, but unfor- 
tunately the treatment is without any effect upon the nervous symp- 
toms, and for this reason asthma cannot be permanently cured. 

The mixture for inhalations which gives the most satisfactory 
results is made of: 

i tablespoonful of Hydrozone, 
i " of pure glycerine. 

Mix well together by shaking the bottle, and renew this mixture 
every three days. 

The duration of each inhalation should not exceed ten minutes, 
and after each inhalation, especially during the winter, the patient 
should remain indoors for fifteen or twenty minutes. 

In cases of long standing it will be found very beneficial to take 
internally, half an hour before each meal, half a tumblerful of ozon- 
ized water made of: 

i ounce of Hydrozone 
with 2 quarts of water. 

This will cleanse the stomach and regulate the bowels. The 
above treatment being earnestly followed will keep the patient free 
from asthma. 

See article headed Dyspepsia page 36. 

Bronchitis. — Treatment. — By means of Charles Marchand's 
Hand Atomizer and Ozonizer three inhalations of ozonized vapor 
should be administered daily, 

It is the most efficacious local treatment which can be prescribed 
to subdue this disease, on account of the harmless, although very 
powerful, antiseptic and healing properties of Hydrozone. 

It quickly checks profuse bronchial secretions, and by its stimu- 
lating action upon the diseased tissues of the bronchial tubes, an abso- 
lute cure is effected in a very short time, particularly in case the patient 
has never used, before, any injurious drugs to relieve his trouble. 

Mixture for inhalations: 

1 tablespoonful of Hydrozone, 

1 " of water, 

2 " of pure glycerine. 

This mixture should be made perfect by shaking the bottle, and 
renewed every three days. In chronic cases it should be made of 
equal parts of Hydrozone and pure glycerine. 



2 4 

• As a beverage, take half an hour before each meal, half a tumb- 
lerful of ozonized water made of: 

i ounce of Hydrozone 
mixed with 2 quarts of water. 

This will have the most beneficial effect upon the stomach, which 
is always affected by droppings from the throat. See article headed 
Catarrh of the Stomach, page 36. 

In most all cases it is necessary to administer immediately after 
each meal 1 teaspoonful of Glycozone diluted with a wineglassful of 
water, in order to heal the local inflammation of the stomach. 

Laryngitis. — Hydrozone is certainly the safest remedy to use 
in order to subdue this disease. 

Spray the larynx or gargle three times every day with a mixture of: 

1 tablespoonful of Hydrozone 

with 4 to 12 tablespooufuls of water. 

Swallow a portion of the remedy. 

Hoarseness which often accompanies Laryngitis is promptly 
subdued by the above treatment. 

In many cases, ozonized vapor inhalations will accelerate the 
cure. 

Pharyngitis. — Spray or irrigate copiously the pharynx at least 
morning and evening every day with a mixture of: 
1 tablespoonful of Hydrozone 
with 6 to 14 tablespoonfuls of water. 

Swallow a portion of the remedy and administer ozonized vapor 
inhalations morning and evening. (See article headed Bronchitis, p 23) 
Appropriate internal medication may accelerate the cure. 

Croup, Membranous Croup. — This disease seems to be 
caused by the same specific virus as Diphtheria, but it shows a milder 
degree of virulence. 

When fully developed, whitish spots or membranous exudations 
are observed in the larynx. After the membrane is once formed, if 
left alone it may be cast off in the form of a cylinder, in bands or 
shreds. Recent experiments have proved that Hydrozone destroys 



2 5 

these membranes after a short contact, and the diseased surface is 
rendered healthy. 

In case of membranous croup, the nose, throat, mouth, pharynx 
and larynx, should be flooded every two hours with a mixture of: 

i tablespoonful of Hydrozone 

with 8 to 12 tablespoonfuls of water (lukewarm.) ■ 

The membranes are destroyed, and by using the remedy fre- 
quently and freely, their reproduction is checked, and there is. no 
danger of the patient being exposed to the suffocation resulting from 
the development of these infected membranes. 

As an internal treatment, i teaspoonful of Glycozone diluted in a 
wineglassful of water, taken three times a day will prevent any dis- 
order of the stomach and regulate the bowels. When the patient's 
stomach is seriously affected, alternate with ozonized water as a bev- 
erage. See "Catarrh of the Stomach," p. 36. 

Whooping Cough. — Causes. — Dr. Burger, of Bonn, Germany, 
and Dr. Affanassieff, of Russia, have shown the presence of micro- 
organisms in Whooping-Cough sputum. Dr. Affanassieff has pre- 
pared, with all the precautions, for microscopical experimentation, 
a small portion of the expectoration of a whooping cough patient, 
which showed large numbers of short rod bacteria, partly singly, partly 
in two and of larger chains. 

With pure cultures of these rod bacteria the investigator has 
made several inoculations upon animals. A solution of this culture 
upon agar-agar, at least eight days old, in one-half a cubic centimetre 
of common salt, was made and injected into the windpipe or lungs of 
dogs and rabbits, of course under antiseptic precautions. 

The animals all contracted a disease similar to Whooping-cough, 
often complicated with Broncho-pneumonia. 

Several died, and the autopsy showed that the mucous membranes 
of the bronchi, of the trachea, and even of the nose, are the chief 
seats of the injected bacteria. 

The same bacteria were found in the lungs and the respiratory 
mucous membranes of children who died of whooping-cough. 

Dr. Affanassieff considers it to be the true cause of Whooping- 
cough, and names it the "bacillus tussis convulsive" 



26 

Hydrozone destroys these germs instantaneously. 

Dr. Schwenker (London Lancet, January 7, 1888) and Dr. Wenat 
{Medical News, June 2, 1888) have confirmed Dr. Affanassieff's obser- 
vations. 

Treatment. — Hydrozone applied in the following manner, will 
promptly effect an absolute cure: 

First. — Spray frequently and copiously the nose, throat, pharynx 
and larynx with a mixture made of: . 

1 tablespoonful of Hydrozone 

with 8 to 20 tablespoonfuls of water (lukewarm) 

The patient may swallow the remedy without discomfort, as it 
is beneficial and perfectly harmless. Three or four applications 
every day will be sufficient in most all cases. 

Second. — By means of the Hand Atomizer and Ozonizer, admin- 
ister ozonized vapor inhalations three to six times daily, in order to 
insure the complete destruction of the microbian element in the 
respiratory organs. 

The mixture for inhalations should be made of: 

1 tablespoonful of Hydrozone, 

1 tablespoonful of water, 

2 tablespoonfuls of pure glycerine. 

Mix well together and renew every three days. 

The disorder of the stomach which often accompanies this dis- 
ease will always be subdued by administering half a tumblerful of 
ozonized water, made of 1 ounce of Hydrozone with 2 quarts of 
water, morning and evening. (See article headed Catarrh of the 
Stomach, page 36.) 

In addition to the ozonized water it will be found beneficial to 
administer as a beverage, 1 teaspoonful of Glycozone diluted with 
water, whenever the patient feels thirsty. 

Consumption, Phthisis, Tuberculosis of the Lungs. — 
Causes. — It is a well demonstrated fact that Consumption or Phthi- 
sis is caused by a microbe of a particular species which has been dis- 



2 7 

covered by Dr. Koch, of Berlin, and which is called the Bacillus 
Tuberculosis of Koch. 

With pure cultures of this bacillus, Dr. Koch and other Bacteri- 
ologists have made experimental inoculations upon animals. A solu- 
tion of this culture upon agar-agar was made and injected into the 
windpipe or lungs of dogs. The animals all contracted the Tuber- 
culosis of the Lungs or Consumption. The bacillus locates itself in 
tubercles, producing ulcerated cavities of the lungs. 

The bacillus tuberculosis is readily destroyed by antiseptic rem- 
edies; but although the annihilation of the microbian element is 
accomplished almost instantaneously by Hydrozone, this remedy could 
not cure Consumption when the disease has reached such a degree of 
development that the lung tissue has broken down. In fact, if it should 
be possible to bring the remedy into contact with all parts of the lungs, 
which are invaded by the bacilli, undoubtedly the cure of Consumption 
might be accomplished by the ozonized vapor inhalations. 

Unfortunately, it is rather difficult, and often impossible to reach 
the seat of the disease, so as to destroy all the germs. Therefore, in 
the majority of cases, the patient could only expect to check the dis- 
ease, preventing the microbian element from invading a new portion 
of the lungs, which is yet in a healthy condition. 

The ozonized vapor treatment will, in all cases, strengthen the 
animal cells of the lungs, and restore their vitality to its normal con- 
dition, so that they become strong enough to either destroy or 
eliminate the vegetable cells (bacilli tuberculosis). At the same time 
it will supply the circulation with the necessary amount of nascent 
oxygen, in its most active condition. 

Treatment. — Frequent and deep inhalations of ozonized vapor 
should be administered three to six times daily with a mixture made 
of: 

i ounce of Hydrozone 

with i ounce of pure glycerine. 

Shake well and renew the mixture every three days. 

The duration of each inhalation should not exceed ten minutes, 
and inspirations should be as deep and as prolonged as possible. The 
remedy will reach the lungs if administered either through the nose or 
mouth, by means of Charles Marchand's Hand Atomizer and Ozoni- 



28 

zer (See pp. 31, 32, ^^), or any other vaporizer made entirely of 
glass and hard rubber, such as the Globe nebulizer of Dr. Dunlap. 

The vaporizer being connected with an air cylinder compressor 
gives much better results. 

Remain indoors for fifteen to twenty minutes after each inhala- 
tion during the cold weather. 

It is easy to understand that, the ozonized vapor coming into 
contact with the ulcerated cavities of the lungs, "ozone," which is set 
free, immediately destroys the microbian element leaving the sur- 
rounding tissues in a healthy condition. 

When consumption has not developed beyond its first or second 
stages — that is, when the ulcerated cavities caused by the bacilli tuber- 
culosis are small and so located that they can be easily reached by 
the ozonized vapor — the above treatment prevents the infection 
from spreading and a cure may be accomplished. But in all cases of 
consumption; no matter at what stage of the disease, the relief of the 
patient will surely and quickly be obtained by using the Hydrozone 
treatment and it will stop or prevent Hemorrhage. 

Ozonized vapor has no corrosive, toxic, or injurious action upon 
the healthy tissues of the lungs, but on the contrary, it acts as a 
powerful stimulant to healthy granulations. 

Although the above local treatment, will always relieve tubercu- 
losis of the lungs, the stomach of consumptive patients being more or 
less in a diseased condition, they cannot digest a sufficient amount of 
food to keep their strength up. Therefore, the antiseptic and 
stimulating treatment of the stomach should be attended to, so as to 
relieve this trouble, in the following manner: 

Half an hour before meals, administer half a tumblerful (or even 
a tumblerful) of ozonized water made of: 
1 ounce of Hydrozone 
with 2 quarts of water. 

This will cleanse the stomach, by destroying the morbid element. 

Immediately after meals, administer 2 teaspoonfuls of Glycozone 
diluted with a wineglassful of water. The stomach will soon be 
brought to a healthy condition, and enabled to properly digest and 
assimilate a sufficient amount of substantial food and thus build up tis- 
sue waste. (See pp. 34-38. Treatment of Diseases of the Stomach.) 



2 9 

INFLAMMATORY AND CONTAGIOUS DISEASES OF THE 

THROAT. 

Sore Throat, Angina, Tonsillitis, Quinsy, etc.— Treatment. 

Spray or gargle the throat copiously and frequently with a mixture of: 
i tablespoonful of Hydrozone 
with 6 to 12 tablespoonfuls of water (cold or lukewarm). 

The patient may swallow the remedy without discomfort, as it is 
rather beneficial. In case of Tonsillar Abscess gargle more fre- 
quently (every two hours,) in order to destroy surely and quickly the 
pus which might cause both suffocation and infection. 

Diphtheria. —Causes. — Diphtheria is at first a local disease 
(see page 2), which is secondarily propagated to the general organ- 
ism by a contagious virus located about the tonsils; this virus is an 
albuminoid substance invaded by a large number of bacteria called 
micrococci, (Klebs-Lcefler Bacilli). 

Hydrozone acting upon this virus, both chemically and mechan- 
ically, changes its nature by coagulating the albumen; the germs are 
readily destroyed, the soil in which they grow is made aseptic, and 
their reproduction is checked. The surrounding healthy animal cells 
of which the vitality had been either weakened or destroyed, recover 
their strength under the stimulating action of this remedy, so that 
they can eliminate or at least resist the deadly action of the vegetable 
cells (germs). 

Infection of the system by ptomaines is therefore prevented and 
the disease remains local. 

When toxic or corrosive remedies are applied (Bichloride of Mer- 
cury, Carbolic Acid, etc.) the germs are readily annihilated, but the 
surrounding healthy animal cells are also destroyed or at least 
much weakened, and the patient may die, not from the disease (since 
the germs are destroyed) but from the effect of the remedy. 

Treatment.— Spray or gargle copiously, every two hours, the 
nose, throat, mouth, pharynx, and larynx with a mixture of: 
1 tablespoonful of Hydrozone 
with 4 tablespoonfuls of water (lukewarm.) 

It is beneficial to swallow the remedy. 

When Diphtheria has developed, spray the child's nostrils, throat, 
mouth, pharynx and larynx more frequently with a mixture of: 



3° 

i tablespoonful of Hydrozone 

with 2 tablespoon fuls of water (lukewarm.) 

Dr. Geo. B. Hope, of the Metropolitan Throat Hospital, of New 
York, and other leading physicians, recommend the use of Hydrozone 
full strength, particularly when the disease spreads rapidly. 

The remedy may be applied full strength to the diphtheritic 
membranes by means of a soft camel's hair brush (free from any 
metallic parts.) 

Any portion of this remedy which finds its way into the larynx 
or stomach is beneficial rather than harmful. 

Adults and children old enough to gargle and rinse the mouth 
will get a better effect in this way. 

As an internal treatment, i teaspoonful of Glycozone diluted in 
a wineglassful of water, administered every three hours, will pre- 
vent the microbian infection developing in the stomach of the patient. 

Scarlet Fever Causes. — It is a proven fact that this disease is 
caused by bacteria of the micrococcus species. 

Every physician knows that Scarlet Fever is a contagious affection 
to the highest degree, and that it may be communicated by anything 
that has touched the patient, such as air, food, clothing, sheets, fur- 
niture, curtains, etc. All discharges from bowels, kidneys, nose, mouth, 
eyes, ears, and skin are dangerous; and the poison may remain active 
for months or years by means of clothing packed away in drawers. 

The germs which cause this disease are readily destroyed by Hy- 
drozone. 

Treatment. — Spray or gargle the throat copiously and repeat- 
edly every two or three hours with a mixture made of: 
i tablespoonful of Hydrozone 
with 6 to 20 tablespoonfuls of water (lukewarm.) 

As a preventive treatment of secondary infection: On the third 
day of Scarlet Fever, the whole body of the patient should be 
washed, morning and evening, with equal parts of Hydrozone and 
tepid water. Use a porcelain dish and a clean soft sponge. 

This local treatment does not preclude the internal medication, 
which may be deemed necessary by the attending physician. 

As an internal treatment: i teaspoonful of Glycozone diluted in a 
wineglassful of water, administered every three to four hours will pre- 
vent the microbian infection developing in the stomach of the patient. 



3i 

DIRECTIONS FOR USING THE HAND ATOMIZER 
AND OZONIZER. 

First. — The proper mixture of Hydrozone with chemically pure 
glycerine for administering ozonized vapor inhalations is thoroughly 
made in the bottle, Z, as is shown on cuts No. 2 and 3; page 32. 

Then, by quickly and repeatedly pressing the terminal soft rubber 
bulb, /, the air is forced through the bottle Z, and produces a coarse 
spray in the vaporizing glass bulb, A. The concussion of the spray 
against the glass breaks up the mixture, and a large amount of fine 
ozonized vapor escapes in a continuous flow through the bent glass 
tube, F, as represented on cut No. 2, or through the straight glass 
tube, F, as shown on cut No 3. 

When the condensed liquid in the bulb, A, reaches the lower 
part Of the neck, F, it should be emptied into the bottle, Z, by dis- 
connecting the spray-tube, D. Then reconnect the parts and the 
apparatus is again ready for use. 

Second. — When the apparatus is needed to spray either the throat 
or the nose, Hydrozone is mixed with the necessary quantity of water 
in the graduated bottle, Z, as shown on cuts No. 4 and No. 5 , page 33. 

CAUTION. 

The spray tube should be kept perfectly clean by passing tepid water 
through it at least twice a week. Should it get clogged, disconnect the 
vaporizing glass bulb, A, and the bottle, Z, unscrew the tip, G, and blow both 
ways through the spray tube, or pass a thin wire through it, as you would 
do for an ordinary spray atomizer. 

The above described apparatusis entirely made of glass and hard rubber, 
because no metal should come in contact with Hydrozone. Use only silver, 
hard rubber, glass or porcelain spoons to measure Hydrozone or Glycozone. 

Note. — Some practitioners believe that Hydrozone may be suc- 
cessfully inhaled by means of any ordinary inhaler, the same being 
placed in a jacket vessel of water heated to i2o°-i4o° Fahr. This 
method is absolutely wrong, for the following reasons: When Hydro- 
zone is heated to i2o°-i4o° Fahr., steam, oxygen (formulaO), and 
only traces of ozone are inhaled by the patient. (See foot note, page 9, 
article headed "Oxygen Inhalation. ') On the contrary, when Hydro- 
zone vapor is mechanically produced by means of the Hand Atomizer 
and Ozonizer the vapor which reaches the diseased tissues has the 
same stimulating and healing properties as Hydrozone. 



32 



CHARLES MARCHAND'S 

COMBINED 

HAND ATOMIZER AND OZONIZER. 

DESCRIPTION: 
C. 




Cut No. i. — This cut represents apparatus when unpacked from its original box. 

sC 1 




Cut No. 2. — This cut represents apparatus ready for inhaling vapor through the 
nose in the treatment of Asthma, Bronchitis and lung diseases. 




Cut No. 3. — This cut represents apparatus ready for inhaling vapor through the 
mouth in the treatment of Asthma, Bronchitis and lung diseases. 



33 



K G 




Cut No. 4.— This cut represents apparatus ready for spraying the throat. 



" 




Cut No. 5.— This cut represents apparatus ready for spraying the nostrils. 



*p 



Each separate part of the appara- 
tus is* designated by the following 
letters: 
A.— The vaporizing glass bulb, with its 

two openings, B and C. 
£).— The curved spray-tube (hard rubber). 
£.— The bent glass tube. 
F.— The slightly curved glass tube. 
G— The straight tip (hard rubber). 
//.—The nasal tip (hard rubber). 
/. /. — The two soft rubber bulbs. 
A".— The soft rubber stopper. 
L. — The glass bottle containing the rem- 
edy. 




CUT No. 6.— This cut shows the different parts of the Hand Atomizer and Ozonizer 
rhen disconnected. 



34 

THE INTERNAL USE OF HYDROZONE AND GLYCOZONE 

IN THE TREATMENT OF DISEASES OF THE 

STOMACH. 

Dyspepsia. — Gastritis. — Predisposing Causes. — Deficient 
gastric secretion, with resulting fermentation of food, is perhaps the 
most prevalent cause of Dyspepsia. 

The two main constituents of gastric juice, namely, acid and 
pepsin, may be deficient in quantity or disturbed in their relative 
proportions. A certain amount of acid is absolutely essential to the 
digestive process, while a small amount of pepsin may be sufficient to 
digest a large amount of albuminoid food. 

Bidder and Schmidt have made repeated analyses of pure gastric 
juice, and their results are confirmed by the analysis of five specimens 
of gastric juices, free from saliva, and taken by me from dogs. 

The gastric juice of a dog is composed of: 

Water , 968.20 

Pepton and Pepsin 17.12 

Free muriatic acid 2.98 

Alkaline chlorides 4.16 

Ammonium chloride 0.51 

Chlorine 5.16 

[ Lime 1.54 

Phosphates -{ Magnesia 0.28 

[Iron 0.05 

The most careful analysis proved beyond doubt that fresh gastric 
juice contains only one mineral acid — that is, muriatic acid. 

Exciting Causes. — The profession well know that excess in 
eating and drinking, imperfect mastication and insalivation, the use 
of indigestible and unwholesome food and the abuse of alcohol, t«he 
imperfect arrangement of meals, over-drugging, etc., (or even the 
moderate use of strong drugs,) are chiefly the exciting causes of Dys- 
pepsia, indigestion being the immediate consequence. 

Either Constipation or Diarrhoea and catarrhal inflammation of the 
bowels are almost universal accompaniments of deranged digestion, 
and when persistent for years are apt to lead to the most disastrous 
consequences. 



35 

Among the direct exciting causes of Gastric Inflammation, cor- 
rosive and poisonous drugs, as well as the excessive use of alcohol are 
recognized to be more prevalent than any others. 

Chronic Catarrh of the Nose is often the cause of Dyspepsia and 
Gastritis on account of the large quantity of infected secretions which, 
after developing in the post-nasal cavities, find their way into the 
stomach. 

The immediate consequence of that constant dropping is to pro- 
duce a catarrhal inflammation of the lining of the stomach, and little 
by little the microbial! infection produces a general morbid condition 
having the symptoms of Catarrh of the Stomach or Gastritis. 

In cases of acute Gastritis the autopsy shows that the mucous 
membrane is covered with a thick, tenacious, stringy mucus, which 
prevents the secretion of gastric juice from being normal, there- 
fore, digestion of food cannot be accomplished. 

The most prominent of the local symptoms of Dyspepsia are: A 
sense of fullness and distension after eating, discomfort during diges- 
tion, lack of appetite and eructations, heart-burn, flatulence, regurgi- 
tation of food, and sometimes, in acute cases, nausea and vomiting. 

Now that I have briefly resumed the causes of dyspepsia and gas- 
tritis, which are always characterized by a general inflammation of the 
wall of the stomach, the profession know that the innumerable reme- 
dies which are prescribed to subdue stomach diseases may be classified 
as follows: 

First, — Remedies having a stimulating action upon the secretion 
and muscular coats of the stomach. 

Second. — Introduction into the stomach of a necessary amount of 
one or several of the constituent elements of the gastric juice, that may 
be in deficiency in order to make it normal. 

Third. — Remedies having the property to lessen the abnormal 
irritability. 

Fourth. — .Remedies having the property to digest food. Although 
some of these remedies may temporarily relieve the symptoms, a cure 
could not be accomplished as long as the cause of the disease is 
not removed by the use of an antiseptic, having no injurious action 
upon healthy animal cells. 

It is well enough to destroy the morbid element which is present 
in the stomach, but it is surely detrimental to the patient to prescribe 



36 

remedies, which may weaken or even destroy the vitality of animal 
cells of the mucous membrane. 

Therefore, the rational treatment of stomach diseases is as follows : 

First.- — Destroy the unhealthy mucus which covers the lining 
membrane of the stomach, without injuring the tissues beneath. 

Second. — Heal the diseased membrane so as to restore the normal 
functions of the peptic glands. 

Hydrozone,' administered (before meals) in the form of ozonized 
water, will destroy the morbid element, but on account of its rapid 
decomposition into nascent oxygen and water, it merely cleanses the 
mucous membrane. Then, Glycozone being administered after meals 
will act upon a clean surface, and owing to its wonderful healing 
properties a cure will promptly be accomplished. See articles headed : 
''Chronic Gastritis with Periodic Attacks of Migraine," by Dr. Geo. 
A. Curriden, p. 214, "Hydrozone in Gastric and Intestinal Disorders,' 
by Dr. John Aulde, p. 216, "Treatment of Inflammatory Diseases of 
the Stomach," by Dr. G. M. Blech, p. 217, "Local Treatment of 
Chronic Gastric Catarrh," by Dr. M. G. Carter, p. 236, "Mechanical 
Feeding of the Insane," by Dr. Frank E. Hoyt, p. 237. 

CHRONIC DYSPEPSIA.— CATARRH OF THE STOMACH 
OR GASTRITIS, AND GASTRIC ULCER. 
Treatment. — First. — Half an hour before meals, administer 
half a tumblerful (or more) of Ozonized Water, made of: 
1 ounce of Hydrozone 
with 2 quarts of water. 
The patient may feel a distressing and sometimes very unpleasant 
sensation in his stomach for a few moments after drinking the above 

remedy. 

This is due to the decomposition (into nascent oxygen) of the 
Ozonized Water, which takes place more or less rapidly according to 
the amount of unhealthy mucus, and degree of inflammation. 

When the inflammation is not acute and the amount of unhealthy 
secretions is relatively small, nascent oxygen is set free rather slowly, 
and the patient does not feel any discomfort. 

On the contrary, when a large amount of unhealthy secretions is 
present, and the mucous membrane is much inflamed, Ozonized Water 
is decomposed almost instantly, and the large amount of nascent 
oxygen which is then suddenly liberated in the stomach, causes a 



37 

distressing sensation which is frequently accompanied with nausea. 
As soon as the stomach becomes more healthy Ozonized Water is 
taken without discomfort. 

Whatever may be the discomfort resulting from drinking ozonized 
water, in all cases of stomach diseases of long standing, (particularly 
when the patient has used all kinds of injurious drugs, which slowly, 
but constantly have aggravated his trouble,) it should be prescribed, 
not only in view of cleansing and disinfecting the stomach, but also, 
in order to restore the vitality of the animal cells of the mucous mem- 
brane, to its normal condition. 

When the animal cell's life has been seriously impaired and even 
totally destroyed by the constant use of strong drugs, although 
Hydrozone is the most powerful life giving and stimulating agent, it, 
may require more or less time (according to the degree of injury 
caused by previous treatment) before the patient feels relieved. 

Second. — The cleansing of the stomach being accomplished by the 
ozonized water, the patient must take immediately after his meal: 
i to 2 teaspoonfuls of Glycozone 
diluted with i wineglassful of water. 

In this way, the healing action of Glycozone takes place upon a 
clean surface to better advantage. 

The relief is almost immediate, and a cure absolute if the above 
treatment is earnestly followed, providing that no other remedies are 
used. 

When Dyspepsia as well as Catarrh of the Stomach is not chronic, 
Glycozone alone, being taken immediately after each meal as above 
explained, may soon accomplish a cure. 

In all cases of stomach diseases, the patient should be careful in 
his diet, avoiding to eat unwholesome food, such as raw vegetables, 
pastry, etc., and he should take his meals regularly; otherwise, it 
might interfere with the beneficial action of both Hydrozone and 
Glycozone. This treatment, which always prevents fermentation of 
food in the stomach, may cure the most acute and chronic cases of 
Dyspepsia and Gastritis, within two to six months, when all other 
remedies have failed. 

Gastric Ulcer, (acute or chronic) which is characterized by vom- 
iting of food and sometimes hemorrhage, is promptly relieved by 



38 

the same above treatment, with the exception, that the patient should 
drink one tumblerful of ozonized water made of: 
i ounce of Hydrozone 
with 2 quarts of water, 
(instead of half a tumblerful) half an hour before meals, and at least 
two teaspoonfuls of Glycozone diluted in a wineglassful of water 
immediately after meals. In this way, Glycozone will heal Gastric 
Ulcer much quicker than if it was administered alone, and the patient 
should not mind the unpleasant distressing sensation which always 
accompanies the use of ozonized water, at first, as it will soon pass 
away when the stomach's condition improves. 

A permanent cure of Gastric Ulcer may be accomplished in less 
than six months, if the above treatment is earnestly followed. 

Indigestion, Vomiting in Pregnancy. — Treatment.— 
Take 2 teaspoonfuls of Glycozone, diluted, with one wineglassful of 
water immediately after eating. 

The relief is immediate and the digestion is accomplished with- 
out discomfort. 

Inflammatory Diseases of the Intestines, Chronic Con- 
stipation, Diarrhoea. — Treatment. — Administer half a tumblerful 
of ozonized water (1 ounce of Hydrozone with 2 quarts of water) 
half an hour before each meal, so as to thoroughly cleanse the 
stomach. 

Then administer immediately after meals: 
1 teaspoonful of Glycozone 
diluted with 1 wineglassful of water. 

In addition to this internal treatment prescribe every day an 
enema with: 

Glycozone, 1 ounce 
Lukewarm water, 12 ounces. 

This mixture should be prepared immediately before using, and 
administered once daily, by means of a hard rubber syringe. Retain 
the enema as long as comfortable. See article headed, "The Thera- 
peutics of Glycozone," by Dr. Cyrus Edson, page 12. 

The temporary discomfort which may follow the administration 
of ozonized water is fully explained on page 36. 

Note, that laxatives and cathartics should be used as little as 
possible because they invariably aggravate constipation. 



39 
CONTAGIOUS DISEASES OF THE ALIMENTARY CANAL. 

TYPHOID FEVER, TYPHUS, YELLOW FEVER, CHOLERA INFANTUM, 
ASIATIC CHOLERA. 

Typhoid Fever. —Causes and Treatment. — It is a well-known 
fact that contaminated water is the cause of this disease. 

Hydrozone destroys the Typhoid Bacillus instantaneously. Con- 
sequently a beverage made of: 

i ounce of Hydrozone with 2 quarts of water, 
alternating with a mixture of: 

Glycozone 1 teaspoonful, water 1 wineglassful, 
is the most efficacious and powerful antiseptic treatment, which 
always prevents septicaemia. Gastric ulcer, which so often follows 
Typhoid Fever (as a consequence of injurious drugs having been 
used) need not be feared when Hydrozone and Glycozone are the 
only prescribed antiseptic remedies. 

This antiseptic medication does not preclude the general treat- 
ment. 

The following article by Dr. Elmer Lee will impart full informa- 
tion in reference to the treatment of Typhoid Fever, and I must say, 
that as a preventive for this disease and for all contagious diseases of 
the alimentary canal, Ozonized water administered internally, will 
always give the most satisfactory results. 

THE TREATMENT OF TYPHOID FEVER. 

By Elmer Lee, A. MM. D., Chicago. 

Read before the Chicago Medical Society, March 5, 1894. 

(Reprint from Chicago Medical Recorder, for April, 1894.) 

Recognition of the value of cleanliness represents the most 
practical discovery in treatment during the present generation, and, at 
the same time it constitutes one of the really great discoveries in the 
history of Medicine. The application of the principles of cleanliness 
more nearly meets the requirements of a real advance in curative 
medicine than all the other propositions known to the profession for 
the cure of disease. 

The symptoms of Typhoid Fever are too well known by all to 
need particular mention; the question of burning interest is what to do 
to be saved. The disease is produced by drinking contaminated 
water, and its seat of development is situated in the intestinal canal. 
There is a poison there which, if it could be removed before it had 
become absorbed into the blood, life and even health would be spared. 



40 

Allowed to remain, the poison is drawn into the circulation, and very- 
soon the whole body feels the depressing effect. Even at this time, 
if those remaining poisonous juices and germs which are contained 
in the bowels were either neutralized by suitable remedies, or washed 
entirely away by a stream of flowing water, the disease would be 
checked, the patient spared, and health restored. 

Without waiting for development of the symptoms of Typhoid 
Fever the very first proposition is to make the patient surgically clean, 
which means the free and abundant use of water internally first, and 
externally afterwards. The bowels are drenched and cleansed by a 
copious douche of hot soapy water,* made to pass into and out of the 
lower bowel, until the contents are cleared away and the returning 
water comes back as clear as before it entered. The relief to the 
sick person by following such ablution is a delight to the physician 
and of greatest comfort to the patient. It seems so reasonable, they 
will say / and in practice it is just as good as they say. Fears were 
formerly entertained by me, as they are to-day by some of my con- 
temporaries, that something would be bursted by running a large 
volume of water into the bowels of persons sick with Typhoid Fever. 
No harm has ever been done, and neither is it likely to be so caused. 
Several hundred cases have been so deluged by me with large quan- 
tities of water, and in no instance has the result failed to be beneficial. 
The fear of doing harm may be entirely and forever dismissed. That 
which is not well understood by anyone, always seems inconvenient 
or troublesome to perform. But a little practice makes easy the 
methods which a little while before appeared unpleasant, even hard. 

The temperature of the water used for cleansing and washing the 
bowels, should always depend upon the temperature of the body. If 
there is high fever the water is more agreeable and useful to the patient 
when it is cool, viz. : 75 degrees F.; but if the patient is chilly, or has 
a low temperature, the water should be at blood heat, nearly 100 
degrees F. During the first week of illness, the irrigation of the 
bowels should take place in the morning and again in the evening of 
each day. After this, one douche of water should be given each day 
until convalescence. The co-operation of the patient is readily 
accorded. The treatment takes hold of his reason, which lends both 
hope and health to the management of the case. 

*Note. — "Elixo" (a vegetable liquid soap) gives the most satisfaction. 



4i 

Bathing the body is performed at regular intervals and by such a 
system as may be convenient and suitable to the individual. The 
bathtub may be used when the patient is strong enough to be assisted 
to it, where otherwise, sponging with cold water is very refreshing, 
and useful to maintain strength and lower the heat of the body. 

The most effective and most lasting influence is secured by 
wrapping the patient in a wet sheet. Two blankets are spread on the 
bed, covered with a sheet wet with cold water. The patient is wrapped 
in a sheet, and then folded quickly and completely in the blankets. 
The time during which the sick one may remain in the wet pack is 
from one-half to one hour, or even longer if he is comfortable. Bath- 
ing opens the pores of the skin, and through them the system dis- 
charges a part of the hurtful waste of the body. This bathing should 
be continued, several times daily during the disease and during con- 
valescence. 

The internal treatment is uncomplicated, safe- and useful. The 
basis of it is cold water, and plenty of it to drink. Water cools the 
body and assists to cleanse it of the poison which makes it sick. The 
elimination is carried on through the lungs and by the skin. Let the 
sick have water, it can do no harm in any case; water only does good. 
What cruelty it was in fever cases, to keep water from them, and 
what suffering it caused. A half tablespoonful of Hydrozone* is 
added to each glass of water. It is the best and most simple remedy 
that can be given that is likely to be of benefit in helping to cure 
Typhoid Fever. Continued for a few days, it is then laid aside for a 
few days and Glycozone substituted in its place, both as a relief to 
the patient and for the beneficial effect of the remedy itself. And so 
on in this way the two remedies are alternated, which is found by me 
to be the best arrangement for administering these valuable antisep- 
tics. The preparation, Glycozone, is chemically pure, redistilled 
Glycerine, in which Ozone, or concentrated Oxygen, has been incor- 
porated, and can be taken with as much freedom and safety as pure 
Glycerine. The Glycozone may be taken in doses of half a teaspoon- 
ful to a glass of water as often as water is taken during the day. 
When it is desired to allay nervousness and induce sleep at night, 
sulphate of Codeine is used, in doses of from one-half to one grain, 

♦Hydrozone now takes the place of Peroxide of Hydrogen, the strength is double, the dose one- 
half. 



42 

by the mouth, or one-quarter to one-half grain by the hypodermic 
method. This remedy tranquilizes the nervous system and induces 
sleep, and should be administered at night. 

The Typhoid Fever patient receives as food, whatever is simple, 
at regular intervals of four hours. Milk, simple, natural milk, is 
nourishment of the highest importance. One egg every day, or 
every other day, is alternated with a small teacup of fresh pressed 
juice from broiled steak or mutton. The egg is pleasant to take and 
more nutritious, when whipped till it is light and then stirred with a 
small glass of milk. For a simple and nourishing artificial food, 
malted milk is always good. 

The juices of fruits are delicious to the Typhoid Fever patient, 
and are not to be dismissed on the supposition that they are injuri- 
ous. It is always interesting to observe that, when the fever is 
broken, and convalescence is beginning, that water in copious 
draughts is no longer easy for the patient to take. When the usual 
glass of water is handed back half drained, it is an encouraging sign 
of beginning restoration. For wholesome drinking, fresh lake water 
which has passed through a Pasteur porcelain filter is entirely 
reliable. 

The simplicity of the foregoing plan meets every requirement, 
and saves nearly every case, unless there is some complication. It is 
my belief that doing more than this is doing less, and less than this 
which is so simple, is not enough. The profession agrees that no 
kind of drug treatment is useful or curative in Typhoid Fever, 
indeed, one of these days, in, my opinion, the statement will be con- 
sidered applicable to other, if not all, cases of diseases of the bowels. 

The plan as proposed by me and practiced during a period of 
five years, consists in review, of the following systematic manage- 
ment in Typhoid Fever. 

Water used internally as a douche for free irrigation of the 
bowels, either simple or made soapy with pure liquid soap. Water as 
a drink, and as a remedy taken copiously and frequently, especially 
during the stage of the fever. Water is indispensable, and should be 
given as often as is desirable and agreeable to the circumstances of 
the case. Frequent application of cool water to the surface of the 
body during the entire illness. 



43 

Remedies: Hydrozone and Glycozone, for the antiseptic effect 
of the oxygen which is set free in the stomach and intestines. But to 
be of real value, these remedies are to be taken in considerable quan- 
tity largely diluted with water, else, in my opinion, they are of little 
use. The capacity of the bowels is so great that a little of anything 
cannot spread over its enormous area to effect it beneficially. Clean- 
liness is the principle governing the use of Hydrozone and Glycozone. 

For a remedy that soothes and brings on sleep at night sulphate 
of Codeine is better than chloral, besides it is the safest and best. 

For food, anything that is simple and in liquid form; milk is 
always the best; milk and whipped eggs; pressed juice from broiled 
meat. The juice from fresh, ripe fruit. The nutrition should be 
taken at regular intervals (four hours), that sufficient time may be 
allowed for digestion. 

Stimulants and drugs are injurious without exception, and better 
results are secured without their use. Typhoid Fever, generally 
transmitted through drinking water, is a preventable disease. Ty- 
phoid Fever affects all classes, but if food and water were always pure, 
no class or age need contract Typhoid Fever. Cleanliness everywhere 
and always is the means at hand which makes it possible to escape 
Typhoid Fever and other diseases of the bowels. Internal cleanli- 
ness as well as external is a reasonable proposition to hope for the 
cure of the unhappy multitude of sick and discouraged humanity. 

Note. — "The use of Peroxide of Hydrogen as an internal remedy 
has been widely opposed by some of my patients, owing to the dis- 
agreeable metallic taste. This objection was partly obviated by the 
use of a large dilution of water, but still not to my entire satisfaction. 

Since reading the foregoing paper, a new antiseptic remedy called 
"Hydrozone" has been received and examined already sufficiently, to 
promise relief from the objections against Peroxide of Hydrogen for 
internal use. Hydrozone has now been substituted by me instead of 
Peroxide of Hydrogen. 

First, on account of its greater bactericide power, as it requires 
but half the quantity of Hydrozone to obtain the same result, and 
secondly, the taste of this remedy is not disagreeable to the patient.'" 

Chicago, May i, 1894. 

See page 92 article headed, "Peroxide of Hydrogen in Typhoid 
Fever," by Dr. H. F. Wiggin; also page 150 article headed, "The 



44 

Treatment of Typhoid Fever," by Dr. M. A. Clark; also page 156 
article headed * 'Diseases of the Alimentary Canal; Treatment by 
Dr. James Osbourn DeCourcy. " 

HYDROGEN PEROXIDE IN CONTAGIOUS DISEASES. 

CHOLERA YELLOW FEVER TYPHUS TYPHOID FEVER. 

By Cyrus Edson, M. D., New York. 

Formerly Commissioner of Health,. Health Department, New York City. 
(Reprint from The Doctor of Hygiene of New York City, April, 1893.) 

It is not my purpose in this short article to laud the merits of 
hydrogen peroxide in the treatment of diphtheria or scarlatinal angina, 
for in the cure of these diseases the remedy in question has no equal. 
Its efficacy cannot be justly questioned. 

Other more competent observers than I have called attention to 
the wonderful effect of this agent in the treatment of ulcers, and 
ulcerating surfaces. The splendid results obtained by numerous dis- 
tinguished physicians and surgeons through the use of hydrogen per- 
oxide in various diseases are well known to the profession. 

I desire, however, to emphasize in a few words the fact that we 
have in H 2 2 a powerful antiseptic agent which may be adminis- 
tered without harm to the human system, and by means of which the 
alimentary canal can be more thoroughly disinfected than by any 
other agent in our present range of therapeutics. In other words, 
there is no other antiseptic that will effect the amount of germ 
destruction in the alimentary canal without inflicting injury. 

This is true for two reasons: 

First, hydrogen peroxide has no toxic properties and conse- 
quently may be administered in larger amounts than can the toxic 
antiseptics. 

Second, hydrogen peroxide ranks higher as a bactericide than 
does any other non-toxic agent, and indeed than do most of the toxic 
ones. 

The elaborate reports made by such men as Paul Bert and Reg- 
niard, Baldy, Gibier, Pean and Larrive prove these two facts as con- 
clusively as they can be proven. 



45 

It logically follows that we have in hydrogen peroxide a curative 
agent from the use of which we may expect good results in cases of 
disease arising from germ infection of the stomach and bowels. 

In this connection one fact must be borne in mind: Peroxide of 
Hydrogen decomposes rapidly in the presence of organic compounds. 
We must consequently administer the drug rather freely in order to 
produce the best effects, and on this account also, free irrigation of 
the lower intestines as devised and recommended by Dr. Elmer Lee, 
of Chicago, {Medical Record, December 17th, 1892), is adapted to 
effect the greatest good. 

The paper by Dr. Lee to which I have just referred, details the 
results of his experiments in the treatment of Asiatic cholera at St. 
Petersburg last year, and advocates the intestinal irrigation for the 
cure of the disease. 

It is impossible to read this able article and not be convinced that 
the methods advanced are in the highest degree scientific and logical. 

The intestinal irrigation is accomplished by means of a soft rub- 
ber tube, one metre in length and of suitable size to be introduced 
into the rectum, in front of the promontory of the sacrum, into and 
up through the sigmoid flexure and into the descending colon. This 
tube which is connected with a reservoir should not be too small nor 
too large, in order to facilitate its introduction through the folds of 
the sigmoid portion of the lower bowel. 

In fact, the greatest difficulty to be encountered, is to .success- 
fully pass the tube in front of the promontory of the sacrum, and 
enter it into the sigmoid flexure. The tube should be of proper firmness 
to prevent it from bending or buckling upon itself when the end 
(which in all cases should be rounded) comes in contact with the 
obstructing folds of the intestine. 

Dr. Lee reports very satisfactory results from a thorough irriga- 
tion of the intestines with warm water containing a small proportion 
of liquid soap made of vegetable oil, potash and glycerine, in connec- 
tion with Peroxide of Hydrogen (medicinal) as an internal treatment. 

By following Dr. Lee's system of irrigation of the intestinal canal, 
with a large amount of the above solution (two or three gallons), the 
whole amount of infected matter which is present in the intestinal 
canal is mechanically carried away; after which, by a second thor- 



46 

ough irrigation of the intestinal canal with one or two gallons of warm 
water containing 4 percent, of Peroxide of Hydrogen, (medicinal) any 
comma-bacilli which may remain in the intestinal canal will be readily 
destroyed. 

In addition to irrigation or washing out of the intestines, Dr. 
Lee administers internally Peroxide of Hydrogen, two ounces diluted 
with eight ounces of distilled water, in cupful doses every two hours. 
The addition of distilled water is made in order to increase the bulk 
of fluid in the stomach. 

It is my opinion that this treatment will prove to be "par excel- 
lence" the treatment for cholera nostras, dysentery, typhus and 
typhoid fever. 

In the latter disease hydrogen peroxide has already been tried 
with beneficial results, administered by the mouth. 

For yellow fever hydrogen peroxide must be considered a spe- 
cific. Gibier has shown that this disease is due to micro-organisms 
that infect the intestines, and basing treatment upon this fact solutions 
of mercuric bichloride have been advocated for intestinal irrigation, 
and large doses of the drug have been exhibited with good results. 

But H 2 2 is a far safer and much more efficacious remedy. It 
has been demonstrated that the germicidal power of a solution con- 
taining two ounces of H 2 2 (medicinal) to a pint of water is equiva- 
lent toa 1/2 per cent, solution of bichloride of mercury. But it is 
evident that we cannot use the latter without killing the patient 
while the former solution is harmless. 

In the treatment of yellow fever Peroxide of Hydrogen should be 
injected into the rectum in the proportion just described, three times 
daily, the water being warm. 

Distilled or boiled water should always be used to effect the dilu- 
tion of hydrogen peroxide, for the reason that the water containing 
organic matter slightly weakens the strength of the peroxide, a cer- 
tain amount of the agent being decomposed. 

This brings to mind another: 

Hydrogen peroxide is a safe and certain water purifier. When 
added to the contaminated water it instantly destroys any micro- 
organisms that the beverage may contain. The proportion necessary 
to effect this is 3 per cent. 



47 

I have used a solution of H 2 2 for washing out the stomach 
through the syphon tube (lavage) in cases of gastric catarrh, with 
most excellent results. 

The therapeutic range of hydrogen peroxide is daily enlarging; 
a comparatively new remedy, it has already won for itself a place in 
the foremost ranks of our really valuable medicinal agents. 

The advance of medical science is necessarily slow, because it 
must follow in the wake of the development of allied sciences upon 
which it depends for its resources. 

Chemistry has only recently given us hydrogen peroxide in its 
pure form and to the efforts of Charles Marchand, of New York, 
more than to any other man, do we owe this invaluable remedy. A 
host of imitators have deluged the market with substitutes for his 
hydrogen peroxide. I have found his preparation facile princeps. 

Note. — Hydrozone will always give better results than Marchand's 
Peroxide of Hydrogen (medicinal) on account of its being twice the 
strength of the Peroxide. 

Yellow Fever.— According to the recent researches made by 
Dr. Paul Gibier, it seems to be a positive fact that yellow fever is 
caused by bacteria which are located in the intestines. This theory 
being supported by other prominent bacteriologists, the most logical 
treatment, in order to subdue this intestinal infection, is to administer 
some laxatives in connection with antiseptic remedies. 

The use of poisonous antiseptics as a rectal injection, should be 
absolutely discarded. 

Treatment. — By means of a glass or hard rubber rectal syringe 
an enema should be administered three times daily, with one pint of a 
mixture made of: 

i ounce of Hydrozone 

with i quart of lukewarm water. 

The patient should retain the enema as long as comfortable, and 
he must drink during the day, three or four tumblerfuls of ozonized 
water, made of one ounce of Hydrozone diluted with 2 quarts of cold 
water, alternating with 1 tablespoonful of Glycozone diluted with 
half a tumblerful of water. 



4 8 

The internal administration of ozonized water during an epidemic 
of Yellow Fever is the safest and most powerful preventive for this 
disease. 

(See articles headed. "Cholera — Prevention and Treatment," by 
Dr. Elmer Lee, page 160; "Hydrogen Peroxide in Contagious Dis- 
eases," by Dr. Cyrus Edson, page 44.) 

Cholera Infantum. — Dysentery. — See pp. 185 and 190. 

These summer complaints heal rapidly under the Ozonized Water 
and Glycozone treatment. 

First. — Administer ozonized water (made of 1 ounce of Hydro- 
zone with 2 quarts of water) half an hour before meals in form of tta 
spoonful to wineglassful doses, depending upon age of child. 

Second. — Administer Glycozone immediately after meals in the 
proportion of 1 teaspoonful diluted with a wineglassful of water. 

In addition to the above local treatment of the stomach, an enema 
should be administered morning and evening with a mixture of: 
1 ounce of Glycozone 
1 pint of lukewarm water. 

The discomfort which may be experienced by the patient at the 
time he drinks the ozonized water is fully explained on page 36. 

The above treatment is safe and most effective in all cases. 

THE USE OF HYDROZONE AND MARCHAND'S EYE BALSAM 

IN THE TREATMENT OF INFLAMMATORY AND 

CONTAGIOUS DISEASES OF THE EYE. 

Marchand's Eye Balsam which is made of chemically pure "Vege- 
table Glycerine" combined with 15 times its own volume of "OZONE," 
is positively harmless, and its healing properties upon diseased tissues 
of the eyes are wonderful. 

Catarrhal Conjunctivitis, or Ophthalmia. -Causes.— The 
profession well know that all forms of conjunctivitis which are accom- 
panied by secretion are caused by germs which develop under more 
or less favorable circumstances, producing a local infection which is 
contagious to the highest degree. 

The virulence of the contagion increases with the impurity of 
the atmosphere, and this disease is communicated by conveyance of 



49 

secretion from one to another, by towels, handkerchiefs, etc., with a 
prodigious rapidity. 

Besides a proper ventilation, it is necessary to isolate sick people, 
and also to keep them perfectly clean, in order to prevent the con- 
tagion; for instance, when any form of conjunctivitis appears in a 
public institution it is urgent to put all the affected persons apart from 
the healthy. 

Numerous analyses which I have made in order to ascertain the 
nature of the remedies ordinarily applied in the treatment of this 
disease show that they are as follows: 

Nitrate of Silver. — Sulphate of Zinc. — Sulphate of Copper. — Bichloride 
of Mercury. — Red Oxide of Mercury. — Calomel. — Carbolic Acid. — Alum. — 
Sugar of Lead.- Tannin. — Borax. — Boracic Acid. — Sulphate of Atropine. — 
Cocaine. — Rose Water, — Etc. 

Although some of these remedies have a powerful destructive 
action upon the microbian element which causes this disease, 
such remedies should be condemned, owing to their corrosive and 
irritating properties. They always have the most injurious effects 
upon the cornea, and very often destroy not only the germs of the 
disease, but also weaken or even destroy the optic nerves; for this 
reason their use proves more dangerous than the disease itself. 

In fact, powerful antiseptics destroy both the germs and the 
healthy tissues with which they come into contact. They also weaken 
the vitality of the healthy animal cells beneath, so that the microbian 
element constantly finds a soil which is favorable to its development. 

Tannin, borax, boracic acid and rose water are not dangerous reme- 
dies, but their bactericide power is so feeble that they could not ac- 
complish a cure. 

On the contrary, Hydrozone, not only destroys the morbid element 
but it restores the diseased tissues to their normal and healthy con- 
dition. 

Marchand's Eye Balsam by its strengthening and healing proper- 
ties makes the mucous membranes of the eye grow stronger daily. 

Treatment. — First cleanse and disinfect the eyelids by a thor- 
ough washing made with a mixture of: 
i ounce of Hydrozone 
with 2 quarts of water, 
then, by means of a glass dropper, apply to the inner portion of the 



5° 

eye, next to nose, one or two drops of the Eye Balsam, every night 
before retiring, and the first thing in the morning. 

If no dropper is at hand, apply the remedy with a soft camel's 
hair brush, dipped in the Eye Balsam, to the outer edge of the eye, 
with an outward motion of the brush, or it may be applied with the 
finger. In whatever manner Marchand's Eye Balsam is applied, it 
penetrates the inner surface of the eye by simply opening and shutting 
the eye repeatedly a few times. 

At first it causes smarting, and often very severe pain for a few 
seconds, but it is only momentary and soon passes away. 

Everybody knows, that owing to excessive tenderness of the 
mucous membrane of the eyes, the application of antiseptic remedies 
always causes a severe pain. Therefore the patient who uses Marchand's 
Eye Balsam, should know that if the application of the remedy is 
quite painful, the relief of his trouble is so promptly obtained, that he 
should not mind the pain. 

Blepharitis heals promptly under the above treatment. 

Purulent Conjuctivitis.— Ophthalmia Neonantorum, or 
Ophthalmia in Children. — The oculists well know that ophthal- 
mia neonatorum, or ophthalmia in children, is much more dangerous 
in its consequences than the catarrhal conjunctivitis. 

This disease, which is the most frequent source of blindness in 
children, can always be cured if treated as follows: 

First. — Cleanse the eyelids by a thorough washing made with a 
mixture of: 

i ounce of Hydrozone 

with i quart of lukewarm water. 

This ozonized water should be used three times, or at least morn- 
ing and evening every day. 

Each cleansing should be immediately followed by the applica- 
tion of Marchand's Eye Balsam. 

See article headed, "Peroxide of Hydrogen in Conjunctivitis," 
page 154. 

Granular Eyelids. — Same treatment as Catarrhal conjunc- 
tivitis. 

In all diseased conditions of the eye, patients should expose 
themselves to air-draughts or bright light as little as possible, and the 
bowels should be kept open by suitable internal medication. 



5i 

Note, that when injurious antiseptics have been used for a long 
time, the animal cells of the mucous membranes of the Eye Lids 
become weak, and it requires more or less time before the ozonized 
water and Eye Balsam treatment will restore their vitality to its nor- 
mal condition, but in all cases, the patient will promptly be relieved, 
and a cure will be accomplished, providing no other remedies are 
applied. 

INFLAMMATORY AND PURULENT DISEASES OF THE 

EAR. 

Owing to its wonderful bactericide properties, Hydrozone is of 
great value in cases of obstinate chronic suppuration of the middle 
ear, especially in such cases where it is difficult to reach all the sup- 
purating tract by any local agent. 

The fact that it can be forced through the osseous sinuses with- 
out danger highly commends its value in these diseases. 

In case of profuse suppuration, the cleansing and destruction of 
pus should be made perfect by applying the remedy in the following 
manner: 

By means of either a glass or a hard rubber syringe, inject repeat- 
edly into the cavity, morning and evening, 8 or 10 drops of Hydro- 
zone full strength. Let the remedy act during two or three minutes, 
then apply as a dressing, a small quantity of absorbent cotton well 
impregnated with Glycozone. 

Two washings with Hydrozone, followed by two dressings with 
Glycozone, made every day, will cure the most obstinate chronic case 
in a very short time. 

When the disease is not chronic, the suppuration being rather 
small, instead of applying Hydrozone, full strength, it should be 
diluted with lukewarm water, in the proportion of i ounce of Hydro- 
zone with 2 ounces of water. 

The local dressing should always be made with pure Glycozone, 
as heretofore explained. (See articles headed "Peroxide of Hydrogen 
and its uses in Ear Diseases," by Dr. Walter B. Johnson, p. 108. "Wax 
in the Ear," by Dr. A. S. Tucker, p. 91. "Hydrozone in Purulent 
Otitis Media," by Dr. Wm. Clarence Boteler, p. 211. "Diseases of the 



52 

Ear, by Dr. Albert H. Buck. Abstract, p. 215. The use of Peroxide 
of Hydrogen in Diseases of the Nose, Throat and Ear, by Dr. W. 
Scheppegrell, p. 224.) 

THE USE OF HYDROZONE IN DENTAL SURGERY. 

See articles headed "Dental Medicine," by R. M.Chase, D. D. S., 
M. D., p. 94. The successful treatment of Rigg's Disease, by H. E. 
Lewis, M. D., p. 180. 

Owing to its wonderful bactericide properties, Hydrozone* 
should always be used in order to cure promptly the dental diseases 
and ulcerations of the mouth, which are known to be caused by patho- 
genic germs, such as, for example: 

Alveolar Abscess and Abscess of the Inferior Maxilla. 

Laceration, Inflammation and Ulceration of the gums, Rigg's 
Disease, Stomatitis, etc. 

Necrosis and Caries of the Teeth. 

The profession well know that the therapeutical agents used for 
the treatment of tfyese diseases have been as follows. 

Chloride of Sodium. — Salicylic Acid. — Chloride of Zinc. — Nitrate of 
Silver. — Creosote. — Carbolic Acid. — Boric Acid, Etc. 

With the exception of chloride of sodium and boric acid, which 
are powerless to destroy the microbial! element, the other above 
mentioned remedies are poisonous, and owing to their corrosive 
properties, the dentists cannot always limit their action to the affected 
parts. 

Creosote and carbolic acid are most objectionable not only on 
account of their being injurious to the surrounding healthy tissues but 
also owing to their offensive odor. They should never be used. (See 
foot note page 10, article headed "The Dangers of Carbolic Acid.") 

On the contrary, Hydrozone is absolutely harmless, its odor and 
taste are rather pleasant than objectionable to the patient. 

By its healing and stimulating properties, the diseased surface is 
made healthy and the surrounding tissues remain in their normal 
condition. 

It has no destructive action upon the enamel of the teeth. 

A tooth, being submitted for several days to the action of 
Hydrozone, full strength, remains intact, but it is bleached. 

Hydrozone should never be made neutral before using. (See p. 7.) 

Alveolar Abscess and Abscess of the Inferior Maxilla. — 
Treatment. — When an Alveolar Abscess is caused by any constitu- 

*It is used without danger or risk of poisoning the patient, and yet it is the strongest bactericide 
and purifier known. (See "Comparative Tests," page 9.) 



53 

tional derangement, internal medication would necessarily have to be 
prescribed. 

The local treatment demanded is such as it will destroy the accu- 
mulated pus.* 

At first the abscess should be broken by surgical operation or 
otherwise, then the cleansing and destruction of pus will be accom- 
plished instantaneously, as follows: 

By means of a silver, gold or platinum syringe, inject into the 
cavity morning and evening, a mixture of: 
i part of Hydrozone 
with 6 to 8 parts of water. 

In case of abscess of the Inferior Maxilla, where there is no free 
egress for the pus and debris, much more energetic treatment is re- 
quired, and the dentist need not hesitate to inject morning and even- 
ing, a mixture of: 

i part of Hydrozone 
with 4 parts of water. 

In chronic cases, in order to prevent the sore from closing be- 
tween two applications, floss silk, or absorbent cotton impregnated 
with glycozone, should be thrust into the cavity immediately after 
each cleansing. 

In addition to the above local treatment, the mouth should be 
kept clean by copious washings (especially after eating), with a mix- 
ture of: 

. i tablespoonful of Hydrozone 
diluted in a tumblerful of tepid water. 

By following this treatment, the diseased tissues become strong 
and healthy after one or two applications, an absolute cure is accom- 
plished in half the ordinary time. 

Laceration, Inflammation, and Ulceration of the Gums — 
Stomatitis — Treatment. — Hydrozone is the most powerful remedy 
which may be applied in order to subdue these tenacious and painful 
affections. 

It should be used freely and repeatedly as a mouth-wash, morn- 
ing and evening, in the following proportion: 
i ounce of Hydrozone 
diluted with a pint of water. 

Rinse the mouth repeatedly, and retain the liquid in the mouth 
for one minute or so at each washing. No injurious action whatever 
upon the enamel of the teeth need be feared. 

The gums are strengthened by this treatment, healthy granula- 
tions develop rapidly, and an absolute cure is quickly effected. 

*When Marchand's Peroxide of Hydrogen is used instead of Hydrozone, the dentist must double 
the above proportions of the remedy to obtain good results. 



54 

When the above diseases of the gums are caused by constitutional 
derangement, internal medication would necessarily be prescribed. 

Necrosis and Caries of the Teeth. — Caries is a very common 
cause of necrosis. Excessive medication, especially with mercury, 
will often produce partial, and, occasionally, total necrosis. 

The profession knows that the most common agents that injure 
the teeth are originated in the mouth by the decomposition of animal 
and vegetable food. 

Inflammation of the mucous membrane of the mouth is a common 
result of diseased teeth. 

The caries may be constitutional or local, and, if constitutional, 
ths dentist knows that it may be modified by therapeutic treatment 
of the general system. 

In all cases of caries, the aggravation of the disease will always 
be checked by using frequently and copiously, as a tooth wash, a 
mixture of: 

2 ounces of Hydrozone 
with a pint of water. 

Rinse the mouth well, at least morning and evening, and retain 
this liquid in the mouth for one minute or so at each washing. 

When the caries is local, the above treatment will promptly 
accomplish a cure. 

Rigg's Disease. — Loosening of the teeth, resulting from vari- 
ous causes, characterizes this peculiar disease. Although all sorts 
of remedies have been used in the treatment of Rigg's disease, still 
the dental profession acknowledge that they failed to even relieve 
their patients of this trouble. 

Hydrozone, by its healing and strengthening action upon the 
gums, checks instantly the development of this trouble when applied 
at an early stage of the disease. 

In that case, the remedy should be used as a mouth wash morn- 
ing and evening, also after eating, in the proportion of: 
2 ounces of Hydrozone 
with one pint of water. 

When the disease has developed, by means of a soft camels hair 
brush, apply Hydrozone, full strength, to the gums, and wash the 
mouth copiously and repeatedly, at least every three hours, also after 
each meal, with a mixture of: 

4 ounces of Hydrozone 
with one pint of water. 

Rinse the mouth well, and retain the liquid for one minute or so 
at each washing. 

The above treatment will accomplish an absolute cure of Rigg's 
disease in a very short time, if earnestly followed by the patient. 



55 

HYDROZONE AS A MOUTH AND TOOTH WASH. 

By means of a medium hard tooth brush, scrub the teeth well and 
rinse the mouth repeatedly with a mixture of: 

Hydrozone, one tablespoonful tepid water, one tumblerful. 

By using this, morning and evening, the mouth and teeth will be 
kept clean, the breath sweetened, and a pleasant and delightful effect 
produced. 

Teething. — Dentition. — In order to either prevent or subdue the 
irritation produced by the pressure of the tooth on the superincumbent 
gum (sometimes causing pyrexia, convulsions, diarrhoea, etc) apply to 
to the gums several times during the day, a mixture of: 
i part Hydrozone 4 parts water. 

CHRONIC AND ACUTE ULCERS. 

Open Sores, Abscesses, Carbuncles, Cancerous Sores, 
Lupus, Burns, Syphilitic Sores, etc. — See the following reports of 
cases: The Operative Treatment of Fistula-in-Ano, by Dr. Lewis H. 
Adler, Jr., p. 109; Wound Closure after the Empyema operation, by 
Dr. Charles W. Aitkin, p. 98; Hydrogen Peroxide in Pelvic Abscess, 
Bacteriological World, editorial, p. 94; An Interesting Case of Em- 
pyema with Special Reference to the Use of Peroxide of Hydrogen 
by Dr. H. F. Brownlee, p. 99; Treatment of Acute and Chronic 
Ulcers, by Dr. James Osborn DeCourcy, p. 147; A Resume of the 
History and Practical Application of Hydrogen Peroxide in Surgical 
Affections, by Dr. S. Potts Eagleton, p. 84; Some of the Uses of 
Peroxide of Hydrogen in General Surgery, by Dr. Th. H. Manley, 
p. no; The Etiology, Diagnosis and Treatment of Ulceration of 
the Rectum, by Dr. Joseph M. Mathews, p. 141; The Necessary 
Peroxide of Hydrogen, by Dr. Robert T. Morris, p. 72; The 
Peroxide of Hydrogen (Medicinal), an Indispensable Wound Sterilizer, 
by Dr. George H. Pierce, p. 106; Sinus Treated with Peroxide of 
Hydrogen, "Practice," editorial, p. 81; Intestinal Obstructions, 
Diagnosis and Treatment, by Dr. Frederick Holme Wiggin, p. in; 
Pathology and Treatment of Indolent Ulcers, by Drs. P. N. Russel, 
G. H. Aiken and A. J. Pedlar of Fresno, Cal., p. 235. 

The fact that Hydrozone»is the most powerful pus destroyer is so 
well established that it is unequalled as a cleansing agent for pus 
discharging surfaces, for the instant it touches pus, "ozone" is set 
free, effervescence takes place and continues until Hydrozone and 
pus are both decomposed. Physicians may apply this remedy with 
perfect safety, even in abdominal surgery, to cleanse and sterilize the 
cavity, and they will always meet with the most satisfactory results in 
the treatment of open sores: 

Hydrozone and Glycozone are successfully used in the treatment 
of the following sores. 

Open Boils, Open Abscesses, PhlegmonousAbscesses,Buboes, Mas- 
toid Abscesses, Acute or Chronic Ulcers (syphilitic or not), Chancres, 



56 

Scrofulous Sores, Cancerous Sores,Bed Sores, Local Gangrene, Broken 
Ampulla or Blisters, Burns, Aphthae or Ulcerations of the Mouth, 
Stomatitis, Rigg's Disease, Skin Disease, Herpes Zoster or Zona, 
Psoriasis, Salt Rheum, Eczema, Poisoning Ivy, Itch, Piles, Fistula, and 
all microbian affections. 

Treatment. — As a rule the above mentioned diseases should be 
treated as follows: 

First. — By means of a glass dropper or otherwise, apply Hydro- 
zone to the sore, and take care not to remove the white foam which 
generates when the remedy comes in contact with the diseased sur- 
face; let it stand until it disappears, which occurs in a few minutes. 

Then, by means of a glass dropper or a soft camel's hair brush, 
apply Glycozone to the sore and complete the dressing with a 
double thickness of surgical lint soaked in Glycozone. Cover the 
whole with oiled silk which will prevent drying. 

It is advisable to apply Hydrozone and Glycozone full strength, 
until the pus formation is checked, but in case of excessive tender- 
ness of the sore, Hydrozone may be diluted with water and Glyco- 
zone should be diluted with chemically pure glycerine. 

When the discharge ceases being abundant, Hydrozone must 
always be used diluted with water, and Glycozone should be thor- 
oughly mixed with chemically pure glycerine, in order to prevent the 
healthy granulations from forming too quickly. 

The degree of dilution should vary with the rapidity with which 
the healthy granulations develop. 

In all cases the dressing should be covered with oiled silk. 

Note, that although Glycozone is deteriorated by the moisture 
of the air, (the deterioration beginning only after i8to 24 hours) when 
it is applied as a dressing to a surface which has been previously 
cleansed and rendered aseptic by Hydrozone, its action takes place 
before the water has impaired its healing properties. Healthy gran- 
ulations develop quickly and the vitality of the surrounding animal 
cells becomes such that they can resist the destructive action of vege- 
table cells (germs). 

Anthrax — Carbuncle. — This affection which is caused by the 
Bacillus Anthracis, is at first a local disease which requires a most 
powerful antiseptic treatment, immediately after the carbuncle has 
been opened by a surgical operation or otherwise. 

The Bacillus Anthracis, is readily destroyed as soon as it comes 
in contact with Hydrozone. See article headed, "Peroxide of Hydro- 
gen and Ozone. Their Antiseptic Properties," by Dr. Paul Gibier, 
p. 73. Hydrozone being twice aspowerful as Marchand's Peroxide of 
Hydrogen (medicinal) its destructive action upon Anthracis Bacillus 
is twice as active. 

Treatment. — Wash or irrigate the sore morning and evening with 
Hydrozone, full strength, taking great care that the liquid should be 



57 

thrust into the discharging sinuses; so as to secure a thorough con- 
tact with the microbial! element; the germs and the pus are destroyed, 
the cleansing and disinfection of the sore being perfect. 

As a local dressing a double thickness of surgical lint should be 
soaked with Glycozone and applied to the sore. Cover the dressing 
with oiled silk. 

The above local treatment does not exclude the internal medication. 

Cancerous Sores.— Gangrenous Sores.— Lupus. — Treat- 
ment. — When a cancer has been thoroughly removed by the knife 
(preferably by means of the thermo-cautery) an absolute cure of 
the wound may be accomplished by repeatedly applying to the sore, 
morning and evening,the Hydrozone full strength, until the cleansing 
has been made perfect. 

Then, as a local dressing, a double thickness of surgical lint 
should be soaked with Glycozone and applied to the sore. Cover the 
dressing with oiled silk. 

Same treatment for gangrenous sores and lupus. 

When cancerous sores have been treated for a long time by 
means of injurious remedies, the life of the surrounding healthy tissues 
is 'impaired to such an extent, that in most all cases, the Hydrozone 
and Glycozone, can only give relief to the patient, and prevent the 
disease from becoming aggravated. 

On the contrary, when these two harmless remedies are used, from 
the beginning, a cure may be accomplished in a very short time. 

The offensive odor which accompanies cancerous sores is thor- 
oughly removed by following the above treatment, and the patient is 
kept comfortable. (See article headed "Peroxide of Hydrogen as a 
Deodorizer in Cancer of the Uterus, page 101.") 

Empyema. — Collection of pus or other abnormal fluid in some 
cavity of the body and particularly in that of the pleura, which is 
called Pleural Empyema, following pleurisy, may be cured by the fol- 
lowing treatment: 

First. — Perform an opening into the pleural cavity and allow the 
pus to run out. 

Second. — By means of a double current hard rubber catheter inject 
slowly into the cavity two ounces of Hydrozone (full strength). The 
gas (white foam) which generates, will find a free egress through the 
outlet opening of the catheter. 

When the accumulation of pus is great (sometimes 4 to 8 quarts), 
the Hydrozone should be injected twice at each dressing, so as to 
thoroughly destroy the pus, and at the same time, check its forma- 
tion. This being done, inject two ounces of Glycozone and insert a 
drainage tube (rubber tubing) into the opening. The patient will be 
relieved at once, and an absolute cure may be accomplished inside of 
two to four weeks. 



58 

No other antiseptics should be used, otherwise it would interfere 
with the cleansing and disinfecting properties of Hydrozone, also with 
the healing action of Glycozone. 

ULCERATION OF THE RECTUM. 
PHAGEDENIC CHANCRE.— FISTULA-IN-ANO.— PILES. 

Ulceration of the Rectum. — When the ulceration is external, a 
cure will be promptly accomplished by frequent and repeated appli- 
cations of a mixture made of: 

i ounce of Hydrozone, 
with 4 to 8 ounces of water. 

When the parts have been thoroughly cleansed and disinfected, 
apply a small quantity of Glycozone all over the surface. Avoid 
scratching. 

In cases of ulceration of the lower gut, inject into the rectum 2 
fluid ounces of the above mixture, 'retain it as long as is comfortable. 

Immediately after evacuation, administer a rectal injection with 
one ounce of pure Glycozone. The above treatment is safe and at 
the same time more powerful than any medication which may be 
prescribed in order to subdue this troublesome disease. 

Phagedenic Chancre of the Rectum.— Treatment. — The 

appropriate internal medication being prescribed by the attending 
physician, will help considerably to accomplish a cure of this disease. 
As a local antiseptic treatment, Hydrozone, full strength, should 
be applied repeatedly, morning and evening. When the sore has 
been thoroughly cleansed and made aseptic, apply a small quantity 
of Glycozone and avoid all external causes of irritation. 

Fistula-in-Ano. — Whatever may be the depth of the fistula, 
and whatever may be the pain which accompanies the application of 
the remedy, Hydrozone, full strength should be injected repeatedly 
morning and evening, by means of a glass syringe, until the cleansing 
of the cavity is made perfect. Usually, three injections administered 
at each dressing will be sufficient. 

This being done insert into the sore a roll of absorbent lint 
impregnated with pure Glycozone, so as to reach as near as possible 
the bottom of the cavity. 

As soon as healthy granulations begin to generate, apply" 
Hydrozone diluted with water in the proportion of 1 ounce of 
Hydrozone with four ounces of water, because it is important that 
the sore should heal slowly. 

See articles headed, ''The Operative Treatment of Fistula-in- 
Ano," by Dr. Lewis H. Adler, Jr., page 109. "Abstract from a 



59 

Treatise on the Diseases of the Rectum, Anus and Sigmoid Flexure," 
p. no, also "The Etiology, Diagnosis, and Treatment of Ulcera- 
tion of the Rectum," by Dr. Joseph M. Mathews, pr 141. 

Piles, (External). — Treatment. — When piles aie external, a 
prolonged bathing of the parts, being attended to, morning and even- 
ing, with a mixture made of 1 ounce of Hydrozone with four ounces of 
water, followed by an application of Glycozone, full strength, will 
accomplish promptly an absolute cure of this trouble, providing the 
constipation (which is usually the cause of this disease) will be sub- 
dued by a proper medication of the alimentary canal. Avoid 
scratching. 

See page 38, article headed, "Constipation." 

Piles, (Internal.) — One ounce of the above mixture of Hydro- 
zone with water, should be injected into the rectum morning and 
evening. Retain it for one minute and inject one ounce of Glycozone. 
Use always a glass or hard rubber syringe. 

Hemorrhage will promptly be. subdued by the above treatment. 

See page 225, article by Dr. M. F. Coomes. 

Note that the frequent use of Cathartics and Laxatives will, in 
most all cases aggravate the piles. (See p. 38 Constipation.) 

INFLAMMATORY AND INFECTIOUS DISEASES OF THE 

GENITO-URINARY ORGANS. 

GONORRHCEA, GLEET, URETHRITIS, ETC. 

Gonorrhoea. — This disease is known to be characterized by a 
local infection of the urethra, which is caused by bacteria of the gon- 
ococcus species. 

These germs, as well as the unhealthy excretions which are pres- 
ent, are destroyed by Hydrozone. Three injections every day, may be 
administered by means of a glass or hard rnbber syringe, with a mix- 
ture made of: 

1 ounce of Hydrozone 
with 10 to 20 ounces of water, 
according to the degree of sensitiveness of the urethra; retain the 
remedy in the canal for a few seconds. 

In case of chronic Gonorrhoea or Gleet, besides the above treat- 
ment, prescribe one injection every night with Glycozone, diluted 
with C. P. Glycerine, half and half. 

See articles headed: "Peroxide of Hydrogen for Gonorrhoea," 
by Dr. R. Charest, p. 69. "The Necessary Peroxide of Hydrogen." 
by Dr. Robert T. Morris, p. 72. "Peroxide of Hydrogen in Diseases 
of the Mucous and Serous Membranes," by Dr. W. S. Mullins, p. 88. 
"The value of Peroxide of Hydrogen in the Treatment of Chronic 
Gonorrhoea," illustrated by a case, by Dr. Wm. Roberts, p. 100. "Per- 



6o 

oxide of Hydrogen in the Treatment of Gonorrhoea," with report of 
case by Dr. John J. Sullivan, p. 125. "The Treatment and Cure 
of Chancre with Peroxide of Hydrogen," by Dr. Willard Parker 
Wooster, p. 149. 

The dangers of stricture resulting from the use of caustic or 
astringent drugs are avoided, and the cure is accomplished in half 
the ordinary time if the above treatment is earnestly followed. 

The appropriate internal remedies such as bromide of potassium, 
bi-carbonate of soda, etc., should be prescribed. 

Avoid all physical causes of local irritation and alcoholic beverages. 

When the degree of inflammation of the urethra is excessive, 
each injection should be preceded by cocaine or ether for the purpose 
of quieting the smarting. See article headed, "The Necessary 
Peroxide of Hydrogen, by Dr. Robert T. Morris, p. 72. 

Note. — As a preventive for inflammatory and contagious diseases 
of the genito-urinary organs (either in the male or female) a thorough 
washing, followed by an injection (immediately after exposure) with a 
mixture of one ounce of Hydrozone to a pint of water, will cleanse 
the parts and destroy the germs instantaneously. No disease what- 
ever need be feared when the above directions are followed. 

WOMEN'S WEAKNESSES. 

Whites, Leucorrhoea, Etc. — These troublesome and distres- 
sing diseases require not only an appropriate internal medication, but 
also a powerful local antiseptic treatment. 

All powerful remedies prescribed to subdue these affections being 
injurious on account of their corrosive, irritating, or poisonous prop- 
erties, frequently aggravate the disease. Mild remedies are merely 
palliative, having no destructive action upon the germs, and conse- 
quently no healing properties whatever. 

On the contrary, Hydrozone, which is harmless, and at the same 
time more powerful than any one of these antiseptics (see p. 9, "Com- 
parative Tests"), has, by its stimulating and healing action upon the 
diseased mucous membrane of the vagina, a prompt and curative effect. 
It destroys both the germs and the unhealthy secretions. 

Treatment. — By means of either a glass or hard rubber foun- 
tain syringe, administer morning and evening copious injections with 
a mixture of: 

1 to 4 ounces of Hydrozone with two pints of lukewarm water, 
according to the amount and nature of the discharge. 



6i 

When the discharge is profuse and its odor offensive, Hydrozone 
should be used diluted with water, in the proportion of 4 to 6 ounces 
of Hydrozone to one quart of lukewarm water. 

The above treatment will promptly accomplish a cure where all. 
other remedies have failed. 

The patient should always lay down when taking an injection. 

In cases of acute inflammation or internal ulceration of the womb, 
cancer of the uterus, gangrene, etc., inject into the uterus morning and 
evening, a mixture of: 

2 to 8 ounces of Hydrozone 
with 1 quart of lukewarm water. 

At night a suitable pledget of prepared lamb's wool, which is tied 
around with a string (for easy removal by the patient) being saturated 
with Glycozone should be introduced into the vagina. (See article 
headed, "Peroxide of Hydrogen as a Deodorizer in Cancer of the 
Uterus," by Dr. G. W. Kaan, p. 101.) 

Caution: It is important to inject Hydrozone into the uterus 
only by means of a double current hard rubber catheter, so as to allow 
a free egress for the nascent oxygen gas which generates when the 
remedy comes in contact with the infected surface, otherwise the pres- 
sure resulting therefrom, might force through the Fallopian tubes some 
unhealthy secretions, which would cause uncontrollable disorders in 
the peritoneal cavity. Peritonitis in its most acute form might set in 
and cause the death of the patient. 

Vaginitis.— Metritis.— Endometritis.— Ulceration of the 
Cervix-Uteri. — These diseases are promptly cured by the use of 
Hydrozone and Glycozone as above explained, but in severe cases the 
remedy must be injected into the uterus full strength until the dis- 
charge ceases being profuse. (See articles headed: "Chronic Cer- 
vical Endometritis. — Osmotic Treatment," by Dr. W. S. Wells, p. 
163; "Local Treatment of Uterine and Vaginal Diseases," by Dr. 
W. C. Wile, page 167;, "Treatment of Vaginitis by Peroxide of Hy- 
drogen." by Dr. Hermann L. Collyer, p. 126; "The Necessary 
Peroxide of Hydrogen," by Dr. Robert T. Morris, p. 72; "Peroxide 
of Hydrogen in Diseases of the Mucous and Serous Membranes," by 
Dr. W. S. Mullins, p. 88; "Hydrozone for Disorders of the Genito- 
urinary Tract," by Dr. John Aulde, p. 229.) 

Pelvic Abscess,— Abscess of the Vagina.— Treatment— 

In case of Pelvic abscess and abscess of the Vagina, the profuse sup- 



62 

puration which follows a surgical operation will be checked by repeated 
injections administered into the sore with Hydrozone full strength. 

From the time the discharge ceases being profuse, inject morn- 
ing and evening a mixture of: 

i ounce of Hydrozone with 16 ounces of lukewarm water. 

In order to secure a prolonged contact of the remedy with the 
diseased surface, the patient must be kept in a recumbent position. 

When healthy granulations generate too quickly under the stimu- 
ating action of this agent, inject (three times every day) a weaker 
solution made of: 

i ounce of Hydrozone with 2 pints of lukewarm water. 

After the cleansing of the sore has been accomplished apply 
Glycozone into the sore, as explained on page 60, article headed 
''Whites, Leucorrhcea." 

Fistula (Recto-Vaginal). — Treatment. — At first inject, into 
the sore, Hydrozone, full strength, until the discharge ceases being 
abundant. 

Then, morning and evening, inject into the cavity, a mixture 
made of: 

1 ounce of Hydrozone with 4 to 8 ounces of lukewarm water. 

The local dressing must be made with Glycozone on absorbent lint- 
See articles by Dr. Lewis H. Adler, Jr., on p. 109. — Dr. J. M. 
Mathews, pp. no and 141. 

INFLAMMATORY DISEASES OF THE BLADDER. 
PURULENT CYSTITIS. 

Cystitis may be acute or chronic; it is always caused by germs. 

In all cases of cystitis the internal medication should be earnestly 
observed, and the patient should not drink irritating beverages. 

The profession well know that the remedies ordinarily applied to 
the local treatment of this disease have rather palliative than cura- 
tive properties. 

In Hydrozone we have a remedy which readily destroys the pus, 
and also the microbian element which causes the disease. 

Hydrozone will always prevent complications which often accom- 
pany cystitis, such as phlebitis, nephritis and gangrene of the blad- 
der. 

Treatment. — By means of a double current hard rubber cathe- 
ter, irrigate the bladder at least morning and evening, with six to 
eight fluid ounces of a mixture made of: 

1 ounce of Hydrozone with 1 pint of water. 



63 

At the beginning of the treatment of chronic cystitis half an 
ounce of Hydrozone full strength, should be injected into the blad- 
der every day, using a double current catheter so that the nascent 
oxygen gas which generates into the bladder will find a free egress 
through the outlet opening. 

In cases of urethritis, acute inflammation or ulceration of the 
bladder when the pain is very great, Dr. Robert T. Morris, recom- 
mends that the application of Peroxide of Hydrogen or Hydrozone 
should be preceded by cocaine or ether, for the purpose of quieting 
the smarting. (See articles headed, "The Necessary Peroxide of 
Hydrogen," by R. T.Morris, M. D., p. 72; Peroxide of Hydrogen 
in Gynecology and in Obstetrics," by Dr. Egbert H. Grandin, p. 
79; Hydrozone for Disorders of the Genito-Urinary Tract," by John 
Aulde, M. D., p. 229.) 

In addition to the above treatment a cure will be accomplished 
in a much shorter time by injecting once daily (after the bladder 
has been cleansed by the Hydrozone solution,) one ounce of Glycozone 
and allowing it to remain in the bladder. 

The above remedies are the most powerful topical agents to use 
in order to subdue inflammatory diseases of the bladder. 

SKIN DISEASES. 

Eczema, Psoriasis, Salt Rheum, Lupus, Itch, Barbers' 
Itch, Erysipelas, Sun Burn, Poisoning Ivy. (See article headed 
"Peroxide of Hydrogen as a Local Application in Rhus Tox Poison- 
ing," by Dr. N. H. Haight, p. 102; also article headed "Poison Ivy," 
by Dr. R. M. Clark, p. 192.) 

Treatment. — First. — Wash the surface with a solution of borax 
made of one ounce of borax for one pint of lukewarm water. Pure 
vegetable liquid soap such as "Elixo," may also be used with good 
results to cleanse the surface. 

Secofid. — By means of a soft camel's hair brush, or by means of a 
spraying apparatus made of hard rubber and glass, apply to the dis- 
eased surface Hydrozone full strength, and let it dry. When it is 
dry, repeat the application of the remedy until the amount of white foam 
which generates is relatively small. 

As soon as the surface is dry, rub over it gently with Glycozone. 
Avoid scratching and cover the parts with lint soaked with Glycozone. 

Two dressings made morning and evening, will promptly accom- 
plish a cure. 

When the disease is due to impurity of blood, a proper internal 
medication should be prescribed. 

In cases of erysipelas, the internal treatment should be prescribed 
by the attending physician in order to subdue the fever. 



6 4 

In cases of psoriasis, salt rheum, in addition to the above local 
treatment the patient must take two teaspoonfuls of Glycozone 
diluted in a wineglassful of water, immediately after each meal, in 
order to subdue the stomach trouble which usually accompanies this 
disease. The internal treatment must be prescribed according to 
the nature of the case. 

Herpes Zoster or Zona. — This disease heals rapidly under 
same above treatment with Hydrozone and Glycozone, and the patient, 
remains free from the itching which always accompanies this trouble. 

Acne, Pimples on the Face. — Treatment. — Whatever may 
be the cause of this disease (if it is due to constitutional derangement 
or not) the patient will always be relieved by the following treatment: 

First. — By means of a sharp needle, open each pimple and avoid 
squeezing. 

Second. — Apply to the diseased surface the Hydrozone full 
strength or diluted with water, according to the degree of sensitive- 
ness. Let the remedy dry. 

Third. — Rub over the surface with Glycozone. 

When the disease is due to blood poisoning, an appropriate inter- 
nal medication must be prescribed by the attending physician. 

Note. — In all cases of Skin Diseases the surface becomes 
intensely red after each application of both Hydrozone and Glycozone. 
This is due to the stimulating action upon the healthy tissues, but 
there is no danger whatever to produce any irritation. 

When the diseased surface is exceedingly tender, use Hydrozone 
diluted with water, in proportions which may vary with the degree of 
sensitiveness of the patient. 

Freckles and Moth Patches can be removed as follows: 

First. — Apply to the surface a solution of borax made of i ounce 
of borax, for one quart of water. Let it dry. 

Second. — By means of a soft camel's hair brush (free from any 
metallic parts) apply to the skin a mixture of equal parts of water and 
Hydrozone. Let it dry. It may cause a slight itching sensation 
which will soon pass away. 

Third. — As soon as the skin is dry, rub over gently the surface 
with a small quantity of Glycozone. 

This treatment must be repeated morning and evening until the 
natural color of the skin has been reached. 

From that time it is necessary to repeat the above at least once 
or twice every week, otherwise the trouble will surely return. 

Dandruff can be removed by applying Glycozone to the scalp, 
•after frequent washings with liquid vegetable soap (Elixo). Rinse 
well with lukewarm water. 



OPINION OF THE MEDICAL PROFESSION. 



SOME CLINICAL FEATURES OF DIPHTHERIA AND THE 
TREATMENT BY PEROXIDE OF HYDROGEN. 

By GEORGE B. HOPE, M. D., New York. 
Surgeon Metropolitan Throat Hospital; Professor Diseases of Throat, University 

of Vermont. 
(Extract from the New York Medical Record, October 13, 1888.) 

The sentiment, so long divided, with regard to the constitutional or local 
inception of diphtheria, seems to be now almost universal in the direction of the latter 
theory. Consequently, in the light of this opinion, it is clear that the rational 
treatment must rest more on the recognition of some local agent which will surely 
destroy the specific germ before a full development of the constitutional infection is 
reached, rather than on any system of general medication which might be presumed 
to act more or less as an antidote in combatting the septic influences occurring in the 
course of the disease 

On account of their poisonous or irritant nature, the active germicides have a 
utility limited particularly to surface or open-wound applications, and their free use in 
reaching diphtheritic formations in the mouth or throat, particularly in children, is 
unfortunately not within the ranges of systematic treatment. In Peroxide of 
Hydrogen, however, it is confidently believed will be found, if not a specific, at least 
the most efficient topical agent in destroying the contagious element and limiting the 
spread of its formation, and at the same time a remedy which may be employed in the 
most thorough manner without dread of procuring any vicious constitutional effect. 
Although the Peroxide is by no means of recent date, its medicinal value has been 
chiefly confined to the cleansing of foul ulcers and suppurating wounds, and there is 
hardly more than a casual mention of its utility in the treatment of diphtheria 
previous to a paper of Dr. Mount Bleyer on this subject.* Quite independently of 
these observations, somewhat over eighteen months since, at the Metropolitan Throat 
Hospital, several cases of well-marked buccal diphtheria were treated with the 
Peroxide, with the effect of confirming in the most satisfactory manner the results 
obtained by Dr. Bleyer. The report of these cases was consequently omitted, 
pending the experiences it was supposed others would be quick to furnish on a more 
extended scale of the new remedy so warmly advocated. Among the somewhat small 
number of trial cases which have appeared at various times in the medical press, there 

* The Medical Record, August 13, 1887 



66 

are none in which a distinctly negative opinion is expressed, and where only a partially 
satisfactory result is attained there has appeared to be sufficient cause to permit 
reasonable explanation for the fact 

A further explanation for the uncertain results attending the use of the Peroxide 
lies in the direction of the preparation itself, as also in the manner of its topical 
application. The usual descriptions allow the diluted strength of from three to seven 
volumes of distilled water. Inasmuch as the efficacy depends upon the ozonized 
oxygen in solution, it has seemed desirable to rely on the full strength of the officinal 
preparation of fifteen volumes, especially when used in the fauces, where any slight 
irritation from its acidity is not apparent. In all the cases treated, a fresh, standard 
Marc hand's preparation of fifteen volumes was that on which the experience of the 
writer has been based. An equally important element is in making the application in 
such a manner as to produce the most determined effect on the diseased tissues with 
as little local disturbances as possible. Swabbing the tonsils and pharynx is the rough 
and ready method commonly resorted to, with the second motive of detaching, if 
possible, the membranous formation. Such treatment is not only unnecessarily 
harsh toward the patient, but also in intrinsic efficacy falls far short in securing the 
best therapeutic value of the remedy. It is properly recognized that the removal of 
the membrane, unless it occurs spontaneously, is not favorable to the local conditions; 
moreover, the glary mucous coating of the surface does not permit the application to 
come fairly in contact with the disease, or so superficially as to require the most 
constant repetition. The latter criticism holds the same bearing, only modified in a 
degree, to the hand-ball vapor and spray-producing instruments that have been 
recommended. 

A steady, coarse spray, with an air-pressure of twenty pounds or more, will in a 
few moments' time produce a more positive action than prolonged efforts to reach the 
fauces by means of cotton applicators. The force of the spray should be sufficient to 
cleanse at once the surface accumulations, as to destroy the necrosial elements with 
which it comes in contact. In this manner the removal of the debris and the action on 
the deeper structure go hand in hand. 

It will be noticed that immediately on contact with the Peroxide, a white, cloudy 
coagulum is formed on and about the diphtheritic patches, readily floated off and 
exposing a more sharply defined and a flatter, smooth and whiter base. Properly 
speaking, there is no liquefaction of the exudation, but the decomposition of the 
inflammatory products is so complete that the cells are broken up and freed from the 
entangling fibrous net-work beneath. In a particular instance, in the case of 
apparently a continuous diphtheritic slough, involving the tonsils and extending in an 
unbroken line across the margin of the soft palate, a solitary application exhibited 
this effect in such a degree that the natural color of the mucous membrane appeared 
in spots as if the exudation might have bridged across sound tissue without as yet 
securing attachment to the sub-epithelial layers. 

How frequently the treatment is to be followed up depends to a considerable 
extend on the density as well as the era of the surface involved. It may be said, 
however, that two applications a day, in the great majority of cases, should be 
sufficient, if thoroughly performed, to arrest all danger of extension and accomplish 
the gradual resolution of the local formation. 

If the experience of the writer is confirmed, it is apparent how much time, 
trouble and unnecessary handling is obviated when contrasted with the methods 
outlining hourly or half-hourly swabbing, or, as one has more frankly expressed it, 
"scrubbing," with nauseating applications, and culminating in the exhaustion of the 
patient, if not the most indifferent success. No reasonable objection can be raised 
either on the score of the expense or the difficulty of transporting the apparatus 
necessary, as small portable air-receivers can be readily obtained in the instrument 
shops, on the model of those devised by Codman & Shurtleff, of Boston, and which 
for the purpose are equally efficient as the larger stationary office fixtures. 



The more recent experience of Dr. Gilford (the Medical Record, September i, 
1888), establishing the active germicidal properties of Peroxide of Hydrogen, rapidly 
diminishing in proportion to its dilution in what might be called a geometrical ratio, 
appears to emphasize in a marked degree the clinical observations on which the main 
features relating to its employment have been based. 



SOME PRACTICAL HINTS IN CONNECTION WITH INTU- 
BATION OF THE LARYNX, AND A RESUME OF 206 
CASES OF DIPHTHERIA OPERATED ON FROM 1886 
TO 1888. 

By J. MOUNT BLEYER, M. D. 

New York Medical Journal^ February 2, 1888. 

{Extract.) 

..... Irrigation. — This is an admirable method of washing away the 

products of the local lesion. I used a No. 8 soft-rubber catheter which is attached to a 

fountain-bag syringe; the catheter is passed into the nostrils, first the right and then 

the left. The solution which is used is made by taking Peroxide of Hydrogen 

(Charles Marchand's), fifteen volume solution, chemically pure, one ounce to twelve 

ounces of water. With this solution irrigate each nostril thoroughly. After this has 

been done, the next move is to wash out the mouth, pharynx and larynx. If the 

child can be managed without forcing the mouth open, there is no need of the 

insertion of a gag; but if not use it. The patient is to be held well forward over a 

basin for the reception of the returning fluid. Make a second mixture of the Peroxide 

of Hydrogen of the strength of four drachms to twelve ounces of water. The catheter 

is passed well down into the larynx, the surrounding parts, and thoroughly irrigated. 

Tne fluids are very seldom swallowed, and if this fluid mixture should be swallowed 

there is no danger of poisoning, as it is a perfectly harmless antiseptic. The fluid is 

generally immediately expelled by coughing. The mouth is to be kept wide open and 

the head well forward. By this mode of treatment patches of membrane, inspissated 

muco-pus, etc., can be washed away without difficulty and without pain. My 

experience with Peroxide of Hydrogen for the last four years has made me familiar 

with its varied use in the treatment of diseases of the nose and throat. From a 

consideration of the action of Peroxide of Hydrogen upon the deposit of diphtheritic 

membranes, and the rapid reproduction of bacteria, it will at once be evident that the 

earlier the application of the remedy is adopted, the better. While the membrane is 

thin and friable, the action of this agent is thorough, quick, and effective; the deposit 

melts down before the contact of it like sugar in water, to be reproduced in a short 

time and again removed until the diseased tissue beneath can be plainly seen free 

from this characteristic covering. In this way, also, the spread of the membrane is 

checked and its limits often sharply circumscribed, until after some days, when the 

germinating power of the membrane is conquered and the poison ceases to produce its 

kind, no more deposit takes place, and the diseased tissues heal. In view of the rapid 

reproduction of bacteria already mentioned, it is evident that the applications should 

be no longer apart than two hours, or even less, according to the rapid reproduction 

of the membranes. Gargling may be practiced by those who are able, but irrigation 

is preferred, as a more thorough application is thereby made. Irrigation is easily 

learned by the nurse, and there is absolutely no danger connected with its use. . . 

For internal use I give the preference to Glycozone, which is chemically pure 



68 

glycerine saturated with active ozone. It is to be used locally, as a substitute for 
bichloride of mercury, carbolic acid, permanganate of potash. This is the most 
powerful of all organic disinfectants and bactericides. I give to a child over two years 
of age half a teaspoonful of Glycozone, well diluted with water or milk, every two 
to four hours, and under that age twenty drops. 



ON THE MEDICINAL USES OF HYDROGEN PEROXIDE. 

By E. R. SQUIBB, M. D., Brooklyn. 

Read before the Kings County Medical Association, February 6, 1889, during the 
discussion on diphtheria, and published in C.aillard's Medical Journal for 
March, 1889, p. 267. 

{Extract.) 

Throughout the discussion upon diphtheria very little has been said of the use of 
the Peroxide of Hydrogen, or hydrogen dioxide, yet it is perhaps the most powerful of 
all disinfectants and antiseptics, acting both chemically and mechanically upon all 
excretions and secretions, so as to thoroughly change their character and reactions 
instantly. The few physicians who have used it in such diseases as diphtheria, 
scarlatina, small-pox, and upon all diseased surfaces, whether of skin or mucous 
membrane, have uniformly spoken well of it so far as the writer knows, and perhaps 
the reason why it is not more used is that it is so little known and its nature and action 
so little understood. Until within the last few years, except in a few manufacturing 
processes, it was chiefly known as a chemical curiosity, rarely seen because difficult to 
make. 

In order to use it intelligently both the pharmacist and the physician must know 
something of its nature and properties. The name hydrogen dioxide expresses its 
composition, and itsformula, H 2 2 represents this name. Hydrogen monoxide, H 2 C), 
or water, can under certain conditions be made to combine with a second molecule of 
oxygen, the result being a water-like liquid, H 2 2 . 

This second atom of oxygen is very loosely combined, and the compound molecule 
is always on a strain to break up into water and oxygen, and when it breaks up, either 
slowly or rapidly, the oxygen separates in that nascent or most active and potent of its 
conditions next to the condition known as ozone. It is in the change of this breaking 
up into the water and active oxygen that the latter element exerts its power, and the 
simple contact with organic matters, which are themselves of complex nature and in 
condition to be changed, is sufficient to break up the dioxide and liberate the active 
oxygen. For example, some albuminoids are instantly changed by contact with 
hydrogen dioxide, as is shown by rinsing the mouth with a dilute solution, when the 
albuminoid matters of the secretions are at once coagulated. Then, as all virus is 
albuminoid, whether propagative or not, it is destroyed, or by coagulation rendered 
inert by simple contact with this agent, just as it is by contact with corrosive 
sublimate. This simple experiment of rinsing the mouth with a dilute solution of 
hydrogen dioxide and examining the discharge of liquid can hardly fail to convince any 
one of the destructive potency of this active oxygen on some albuminoids, and of its 
thoroughly cleansing effects upon the mucous surfaces. 

Now, if diphtheria be at first a local disease, and be auto-infectious — that is, if it 
be propagated to the general organism by a contagious virus located about the tonsils, 
and if this virus, be as it readily is an albuminoid substance, it may and will be 
destroyed by this agent upon a sufficient and a sufficiently repeated contact. 
All kinds of spray and injection apparatus can now be easily obtained with fittings of 
hard rubber or glass, and such only should be used. 



6 9 

A child's nostrils, pharynx, and mouth may be flooded every two or three hours, or 
oftener, from a proper spray apparatus with a two-volume solution without force, and 
with very little discomfort; and any solution which finds its way into the larynx or 
stomach is beneficial rather than harmful, and thus the effect of corrosive sublimate is 
obtained without its risks or dangers. Adults and children old enough to gargle the 
pharynx and rinse the mouth will get a better effect in this way, equally without much 
discomfort, from a three- volume solution; and this applies not only to diphtheria, but 
to scarlatina and other conditions of the mouth and throat which require cleansing and 
disinfecting. As vaginal injections in cases of uterine cancer, etc., the strength must 
be increased until the disinfectant effect is obtained. A copious flushing out with a 
one-volume solution will often be sufficient. When wetted cloths aie laid over external 
sores an over-covering of oiled silk should be used. 

As, in passing through several hands after leaving those of the maker, a little 
mismanagement may spoil the solution, some easily applicable tests of quality and 
strength are needed. 

So long as the solution will yield any active oxygen at all, it will give this off with 
active effervescence when poured onto a crystal or two of potassium permanganate. 
A solution containing only a quarter of its volume will give an effervescence so strong 
as to be misleading, and therefore a quahtitive test is needed. The following is a 
modification of a testing process given to the writer, with much other useful information 
by Mr. Charles Marchand, of No. 10 West 4th Street, New York City, one of the 
oldest and best makers of Peroxide of Hydrogen, and one who supplies it to all parts 
of the country. 

If this agent is to be generally used in the treatment of diphtheria, as it well 
deserves to be on well established principles of action, it is very important that it be 
freely applied in the earliest possible stages of the disease, or while it is yet local; and 
therefore the agent should be easily and promptly accessible in places known to physi- 
cian?, and not over a mile apart throughout the city, and in hands which know the agent 
well, and know how to keep it from change and to dispense it on physicians' orders. 

If all pharmacists should undertake to keep it — or even all the prominent ones — 
it would soon share the fate of many other important medicines. . . . 



PEROXIDE OF HYDROGEN FOR GONORRHOEA. 

Report of R. CHAREST, M. D., St. Cloud, Minn. 
{Medical World, Philadelphia, Pa., June, 1889.) 

Editor Medical World: 

I intended for some time to give to the readers of the Afedical JVorld my favorite 
treatment for gonorrhoea and gleet, and I will take the opportunity of Dr. H. E 
Stroud's offer to do so now. 

What I consider the simplest, quickest and least harmful treatment of gonorrhoea 
is Peroxide of Hydrogen in injection a j to the § of distilled water, three to five times 
a day. 

Internally ten to fifteen grains of soda bicarb., every three hours, to keep the 
urine alkaline. 

Walking to be avoided as far as possible, also beer, coffee, pepper, etc.; keep the 
bowels regular; use a syringe with tapered end and soft rubber tip for the injections. 

The Peroxide of Hydrogen is used a good deal in commerce for bleaching pur- 
poses, so there are different qualities of it on the market. 

For medical use it must be neutral to the litmus paper, odorless and colorless.* 

* See page 5, article headed "Important Information on Peroxide of Hydrogen." 



7° 

This kind you may have from C. Marchand, ioWest Fourth Street, New York City. It 
must be kept at a temperature below 65 F , and no metal must come in contact with it. 

In writing to the above-named firm you will receive a pamphlet on this valuable 
remedy well worthy to be studied. 

I consider it the best germicide, as it is the least harmful and the most effective. 
For the past two weeks I have used it in the form of a spray, in one of the worst 
cases of eczema, of four years' standing, which had so far resisted the assaults of a 
dozen doctors backed up by as many drug stores, and is now almost well. 

For syphilitic ulcers, soft chancres, diphtheria, ulcerated cervix, in fact, whenever 
there is pus or germs, this is the true remedy. 

In gonorrhoea, when the penis is highly inflamed, use the injection four to five 
times a day and the inflammation will rapidly be subdued, leaving the urethra in a 
perfectly healthy condition. The use of a suspensory is a great relief to the patient. 

The fl. ext. of black willow is very good for the erections. 

It is also the remedy par excellence in gieet, and there is nothing like its inhalation 
to cut short a paroxysm of asthma. 

I don't claim the Peroxide of Hydrogen (H 2 2 ) to cure gonorrhoea in three or 
eight days, for I don't believe there is anything that will do so without danger; but it 
will cure it in three weeks and leave the unfortunate in the best of condition. 



MEDICINAL USE OF HYDROGEN PEROXIDE. 

(Editorial Netv York Medical Record.) 

It is with pleasure that we peruse the new issue of Squibb 's Ephemeris for July,. 
1889, confident as we are that whatever it tells us in accord with the latest scientific 
advances, and is the result of careful thought and research. Among its articles is one 
by E. R. Squibb, on "Hydrogen Peroxide" (published also in Gaillard's Medical 
Journal, March, 1889). This substance which is one of the most powerful and at the 
same time the least harmful of all antiseptics and disinfectants, has never come into 
general use, probably because it is so unhandy and spoils so readily (Dr. Squibb thinks 
it is because it is so little known and so little understood). It is made in large quanti- 
ties by several large firms, but is used chiefly in the preparation of secret remedies. 
Its properties have been known for a longtime. It is a compound of hydrogen and 
oxygen which is easily decomposed, yielding water and nascent oxygen which quickly 
oxidizes substance with which it is in contact. The mere application of a solution of 
Peroxide of Hydrogen to certain albuminoid substances is sufficient to liberate its oxy- 
gen, which immediately coagulates the albuminoid substance within its reach. Thus 
all sorts of virus, whether propagative or not, are destroyed, or by coagulation rendered 
inert in ks presence, just as when strong corrosive sublimate solutions are applied to 
them. The undiluted liquid peroxide is from its nature very unstable, and on slight dis- 
turbance breaks up into water and oxygen with almost explosive rapidity. Therefore it 
is never made nor used undiluted, but is always dissolved in water. The "Peroxide of 
Hydrogen" which is furnished to the physician is really a solution of the pure liquid 
in water to which a little hydrochloric acid has been added, the acid being necessary to 
prevent rapid decomposition of the peroxide. A solution which will yield its own 
volume of active (nascent) oxygen is called a one-volume solution. The fifteen volume 
solution (yielding fifteen times its volume of nascent oxygen) is that which is generally 
supplied by the makers. It is put up in pint bottles, containing about fifteen fluid 
ounces, sold at $9 a dozen. It is colorless and nearly odorless, tastes slightly acid, 
and leaves a slight fleeting, not unpleasant after-impression. Changes in this solution 
are indicated by the formation of bubbles of gas, which rise through the liquid or 



7i 

adhere to the sides of the bottle, and also by increased- pressure within the bottles. 
At or below 59 F., the solution does not change for a long time. At 68 e F„ it does 
change, sometimes very rapidly, giving off oxygen gas. The solutions, whether strong 
or dilute, should be kept cool, outside of the window of the sick-room in winter, and 
on ice or in ice-water in summer. The bottles in which the solutions are contained 
must not be held in the hand for any considerable time, as its warmth will cause 
decomposition. It must not be kept in contact with metals, nor applied by means of 
metal apparatus, as it not only ruins the instruments, but forms poisonous salts from 
the metal. It does not attack hard rubber or glass. It is not necessary to apply it as 
strong as when it comes from the maker. The ordinary fifteen-volume solution sold 
is not injurious, but it is stronger than necessary, and to use it undiluted is wasteful. 
For the irrigation of a child's nostrils, pharynx, and mouth, a two-volume (made by 
adding two ounces of the fifteen volume solution to a pint of water solution,) may be 
used every two or three hours, and any part of this solution passing into the stomach 
will do good rather than harm. 

Adults and children who can gargle — especially in scarlatina and diphtheria — may 
use, as a gargle and mouth-wash, a three-volume solution /three ounces of fifteen- 
volume solution to a pint of water). For vaginal injections, as in cancer, etc., a 
thorough washing with the one- volume solution will always suffice, but it may be neces- 
sary to increase the strength until the desired effect is produced. When cloths wetted 
in a solution are laid upon external sores they should be covered with oiled silk. The 
methods for testing the activity of any solution are given in full, but need not be 
repeated here. Mr. Charles Marchand, of No. 10 West Fourth Street, New York 
City, is referred to as one of the best makers and furnishers of hydrogen peroxide. 
It is very necessary to get a good article, as careless preparation and after-handling- 
may render it inactive. It is desirable that it should be applied very early when used 
in diphtheria, before the deposits in the throat have caused disease of the adjacent 
parts or of the general system. 



PEROXIDE OF HYDROGEN FOR THE RELIEF OF BITES 
FROM VENOMOUS INSECTS. 

By PHILIPPE RICORD, M. 1)., Newark, X. J. 

(Page 14S, New York Medical Record, February 8, 1S90.) 

"Recently, while charging my atomizer with the full strength of fresh standard 
Marchand's preparation of Peroxide of Hydrogen, at the bedside of a child suffering- 
with diphtheria, my attention was attracted by the patient's mother, who appeared in 
pain, and stated that while taking up a blanket to wrap about her child she supposed 
she had been pricked by a needle, and on further examination discovered a hornet 
between the folds she had touched. Thereupon I immediately directed the Peroxide 
of Hydrogen spray into the wound, the surrounding tissues in a few seconds that 
had elapsed, being swollen to such an extent as to distinctly mark its site. Instantly 
all pain ceased, and the swelling rapidly disappeared. In this case the wound was 
still sufficiently open to readily admit the Peroxide of Hydrogen, and the destruction 
of the virus was apparently in a moment so completely accomplished that no further 
treatment was afterward required. May we not, therefore, infer that it is quite 
possible to annihilate many other poisons, likewise, by the prompt application of so 
powerful yet safe an agent as the Peroxide of Hydrogen?" 



12 

THE NECESSARY PEROXIDE OF HYDROGEN. 

Read in the Section of Surgery and Anatomy, at the Forty-first Annual Meeting of 
the American Medical Association, held at Nashville, Tenn., May, 1890. 

By ROBERT T. MORRIS, M. D., New York. 

Published by the Journal of the American Medical Association, Chicago, August 9, 

1S90, page 216. 

Stop suppuration! That is the duty that is imposed upon us when we fail to pre- 
vent suppuration. 

As the ferret hunts the rat, so does Peroxide of Hydrogen follow pus to its narrowest 
hiding place, and the pyogenic and the other micro-organisms are as dead as the rat 
that the ferret catches when the Peroxide is through with them. Peroxide of Hydro- 
gen, H 2 2 , in the strong 15-volume solution, is almost as harmless as water; and yet, 
according to the testimony of Gifford, it kills anthrax spores in a few minutes. 

For preventing suppuration we have bichloride of mercury, hydronaphthol, carbolic 
acid, and many other antiseptics; but for stopping it abruptly, and for sterilizing a 
suppurating wound, we have only one antiseptic that is generally efficient, so far as I 
know, and that is the strong Peroxide of Hydrogen. 

Therefore I have qualified it, not as "good" not as "useful" but as "necessary." 
In abscess of the brain, where we could not thoroughly wash the pus out of tortuous 
canals without injuring the tissues, the H 2 2 injected at a superficial point will follow 
the pus, and throw it out, too, in a foaming mixture. It is best to inject a small quan- 
tity, wait until foaming ceases, and repeat injections until the last one fails to bubble. 
Then we know that the pus cavity is chemically clean, as far as live microbes are 
concerned. 

In appendicitis, we can open the abscess, inject Peroxide of Hydrogen, and so 
thoroughly sterilize the pus cavity that we need not fear infection of the general peri- 
toneal cavity, if we wish to separate intestinal adhesions and remove the appendix 
vermiformis. Many a patient, who is now dead, could have been saved if Peroxide of 
Hydrogen had been used when he had appendicitis. 

The single means at our disposal allows us to open the most extensive abscess psoas 
without dread of septic infection following. 

In some cases of purulent conjunctivitis, we can build a little wall of wax about 
the eye, destroy all pus with Peroxide of Hydrogen, and cut the suppuration short. 
Give the patient ether, if the H 2 2 causes too much smarting. It is only in the eye, 
in the nose and in the urethra that Peroxide of Hydrogen will need to be preceded by 
cocaine (or ether) for the purpose of quieting the smarting, for it is elsewhere almost 
as bland as water. 

It is possible to open a large abscess of the breast, wash it out with H 2 2 , and 
"have recovery ensue under one antiseptic dressing, without the formation of another 
drop of pus. 

Where cellular tissues are breaking down, and in old sinuses, we are obliged to 
make repeated applications of the H 2 2 for many days, and in such cases I usually 
follow it with balsam of Peru, for balsam of Peru, either in fluid form or used with 
sterilized oakum, is a most prompt encourager of granulation. 

If we apply H 2 O s on a probang to diphtheritic membranes at intervals of a few 
moments, they swell up like whipped cream and come away easily, leaving a clean 
surface. The fluid can be snuffed up into the nose and will render a foetid ozoena 
odorless. 

It is unnecessary for me to speak of further indications for its use, because wher- 
ever there is pus we should use Peroxide of Hydrogen. We are all familiar with the 



73 

old law "Ubi pus, ibi evacua," and I would change it to read " Ubi pus, ibi evacua, 
ibi hydrogen urn peroxidum infunde." That is the rule. The exceptions which prove 
the rule are easily appreciated when we have them to deal with. 

Peroxide of Hydrogen is an unstable compound, and becomes weaker as oxygen is 
given off, but Marchand's 15-volume solution will retain active germicidal 
power for many months if kept tightly corked in a cold place. The price of 
this manufacturer's preparation is $1.00 per lb., and it can be obtained from any 
large drug house in this country. When using the H 2 2 it should not be allowed to 
come into contact with metals if we wish to preserve its strength, as oxygen is then 
given off too rapidly. 

H 2 2 must be used with caution about the hair, if the color of the hair is a matter 
of importance to the patient; for this drug, under an alias, is the golden hair bleach 
of the nymph's despare, and a dark-haired man with a canary-colored moustache is a 
stirring object. 



PEROXIDE OF HYDROGEN AND OZONE. 
THEIR ANTISEPTIC PROPERTIES. 

Read before the International Medical Congress, held at Berlin, Germany, on the 7th 
of August, 1S90. Published by Medical News of Philadelphia, October 25, 1890. 
Pp. 416-41S. 

By PAUL GIBIER, M. D. 
Director of the Pasteur Institute of New York. 

Gentlemen: 

Since the discovery of Peroxide of Hydrogen by Thenard, in 1818, the therapeut- 
ical application of this oxygenated compound seems to have been neglected both by the 
medical and the surgical professions; and it is only in the last twenty years that a few 
bacteriologists have demonstrated the germicidal potency of this chemical. 

Among the most elaborate reports on the use of this compound may be mentioned 
those of Paul Bert and Regnard, Baldy, Pean and Larrive. 

Dr. Miguel places Peroxide of Hydrogen at the head of a long list of antiseptics, 
and close to the silver salts. 

Dr. Bouchut has demonstrated the antiseptic action of Peroxide of Hydrogen, 
when applied to diphtheritic exudations. 

Prof. Nocart, of Alfort, attenuates the virulence of the microbe symptomatic of 
carbuncle, before he destroys it, by using the same antiseptic. 

Dr. E. R. Squibb,* of Brooklyn, has also reported the satisfactory results which 
he obtained with Peroxide of Hydrogen in the treatment of infectious diseases. 

Although the above-mentioned scientists have demonstrated by their experiments 
that Peroxide of Hydrogen is one of the most powerful destroyers of pathogenic 
microbes, its use in therapeutics has not been as extensive as it deserves to be. 

In my opinion the reason for its not being in universal use is the difficulty of 
procuring it free from hurtful impurities. Another objection is theunstableness of the 
compound, which gives off nascent oxygen when brought in contact with organic 
substances. \ 

Besides the foregoing objections the surgical instruments decompose the peroxide, 
hence, if an operation is to be performed, the surgeon uses some other antiseptic during 

* Gaillard" s Medical Journal, March, 1889. 

+ The Peroxide of Hydrogen that I use is manufactured by Mr. Charles Marchand, of New York. 
This preparation is remarkable for its uniformity in strength, purity and stability. 



74 

the procedure, and is apt to continue the application of the same antiseptic in the sub- 
sequent dressings. 

Nevertheless, the satisfactory results which I have obtained at the Pasteur Institute 
of New York with Peroxide of Hydrogen, in the treatment of wounds resulting from 
deep bites, and those which I have observed at the French clinic of New York, in the 
treatment of phagedenic chancres, varicose ulcers, parasitic diseases of the skin, and 
also in the treatment of other affections caused by germs, justify me in adding my 
statement as to the value of the drug. 

But, it is not from a clinical standpoint that I now direct attention to the anti- 
septic value of Peroxide of Hydrogen. What I now wish is merely to give a full report 
of the experiments which I have made on the effects of Peroxide of Hydrogen upon 
cultures of the following species of pathogenic microbes: Bacillus anthracis, bacillus 
pyocyaneous, the bacilli of typhoid fever, of Asiatic cholera, and of yellow fever, 
streptococcus pyogenes, micro-bacillus prodigiosus, bacillus megaterium, and the 
bacillus of osteomyelitis. 

The Peroxide of Hydrogen which I used was a 3.2 per cent, solution, yielding fifteen 
times its volume of Oxygen; but this strength was reduced to about 1.5 per cent., cor- 
responding to about eight volumes of Oxygen, by adding the fresh culture containing 
the microbe upon which I was experimenting. I have also experimented upon old 
cultures loaded with a large number of the spores of the bacillus anthracis. In all cases 
my experiments were made with a few cubic centimetres of culture in sterilized test- 
tubes, in order to obtain accurate results. 

The destructive action of Peroxide of Hydrogen, even diluted in the above pro- 
portions, is almost instantaneous. After a contact of a few minutes, I have tried to 
cultivate the microbes which were submitted to the peroxide, but unsuccessfully, owing 
to the fact that the germs had been completely destroyed. 

My next experiments were made on the hydrophobic virus in the following manner: 

I mixed with sterilized water a small quantity of the medulla taken from a rabbit 
that had died of hydrophobia, and to this mixture added a small quantity of Peroxide 
of Hydrogen. Abundant effervescence took place, and as soon as it ceased, having 
previously trephined a rabbit, I injected a large dose of the mixture under the dura 
matter. Slight effervescence immediately took place and lasted a few moments, but the 
animal was not more disturbed than when an injection of the ordinary virus is given. 
This rabbit is still alive, two months after the inoculation. 

A second rabbit was inoculated with the same hydrophobic virus which had not 
been submitted to the action of the peroxide, and this animal died at the expiration of 
the eleventh day with the symptoms of hydrophobia. 

I am now experimenting in the same manner upon the bacillus tuberculosis, and if 
I am not deceived in my expectation, I will be able to impart to the profession some 
interesting results. 

It is worthy of notice that water charged, under pressure, with fifteen times its 
volume of pure oxygen has not the antiseptic properties of Peroxide of Hydrogen. 
This is due to the fact that when the peroxide is decomposed nascent oxygen separates 
in that most active and potent of its conditions next to the condition, or allotropic form, 
known as "Ozone." Therefore it is not illogical to conclude that ozone is the active 
element of Peroxide of Hydrogen. 

Although Peroxide of Hydrogen decomposes rapidly in the presence of organic 
substances, I have observed that its decomposition is checked to some extent by the 
addition of a sufficient quantity of glycerine; such a mixture, however, cannot be kept 
for a long time, owing to the slow but constant formation of secondary products, 
having irritating properties. 

Before concluding I wish to call attention to a new oxygenated compound, or 
rather ozonized compound, which has been recently discovered and called "Glycozone" 
by Mr. Marchand. 

This Glycozone results from the reaction which takes place when glycerine is 



75 

exposed to the action of ozone under pressure — one volume of glycerine with fifteen, 
volumes of ozone produces Glycozone. 

By submitting the bacillus anthracis, pyocyaneous, prodigiosus, and megaterium 
to the action of Glycozone, they were almost immediately destroyed. 

I have observed that the action of Glycozone upon the typhoid fever bacillus, and 
some other germs, is much slower than the influence of Peroxide of Hydrogen. 

In the dressing of wounds, ulcers, etc., the antiseptic influence of Glycozone is 
rather slow if compared with that of Peroxide of Hydrogen, with which it may, how- 
ever, be mixed at the time of using. 

It has been demonstrated in Pasteur's laboratory that glycerine has no appreciable 
antiseptic influence upon the virus of hydrophobia; therefore, I mixed the virus of 
hydrophobia with glycerine, and at the expiration of several weeks all the animals 
which I inoculated with this mixture died with the symptoms of hydrophobia. 

On the contrary, when glycerine has been combined with ozone to form Glyco- 
zone, the compound' destroys the hydrophobic virus almost instantaneously. 

Two months ago, a rabbit was inoculated with the hydrophobic virus, which had 
been submitted to the action of this new compound, and the animal is still alive. 

I believe that the practitioner will meet with very satisfactory results with the use 
of Peroxide of Hydrogen for the following reasons: 

1. This chemical seems to have no injurious effect upon animal cells. 

2. It has very energetic destructive action upon vegetable cells — microbes. 

3. It has no toxic properties; five cubic centimetres injected beneath the skin 
of a guinea-pig do not produce any serious result, and it is also harmless when given 
by the mouth. 

As an immediate conclusion resulting from my experiments, my opinion is, that 
Peroxide of Hydrogen should be used in the treatment of diseases caused by germs, if 
the microbian element is directly accessible; and it is particularly useful in the treat- 
ment of infectious diseases of the throat and mouth. 



HYDROGEN PEROXIDE IX DIPHTHERIA. 
By DAVID PHILLIPS, M. D. 
(Extract from the New York Medical Journal, December 6, 1890.) 
To the Editor of the New York Medical Journal: 

Sir: — I would suggest the following local treatment for diphtheria: The applica- 
tion to the membrane of Marchand's solution of Peroxide of Hydrogen, fifteen volumes, 
with an equal bulk of water, then scraping the membrane off with a curette and apply- 
ing the Peroxide of Hydrogen, one-third dilution, every hour for six or seven hours, 
then every two hours. If there is no reappearance of membrane after two days, spray 
the throat occasionally with an antiseptic spray. In this way the membrane is 
removed at once. The operation is done at a period of the disease when there is no 
danger of heart failure, so that the struggles of a child need not be minded. 

I am aware that the removal of the membrane in former years was regarded as 
somewhat dangerous, but at that time nothing was known of disinfectants and germi- 
cides. 

It would seem that a remedy which, applied to the diphtheritic membrane, 
removed it after some hours, would prevent its formation. In tolerant patients the 
peroxide may be put on three or four times so as to be sure of complete disinfection 
before curetting. A small Thomas' uterine curette answers the purpose admirably. 
A patient treated as described was comparatively well in two days. 



7 6 

PEROXIDE OF HYDROGEN. 

By A. LIVEZEY, M. D., Yardley, Pa. 

(Extract from Medical Summary, December, 1890. Page 214.) 

After trying for the past five years innumerable therapeutic agents for my lupus 
•or epithel'oma, I was advised by Dr. Cutter, a celebrated microscopist and scientist of 
]New York, to spray the ulcer with the peroxide and afterwards apply cotton saturated 
with the same. I used three different local applications, aristol, Howe's salve, and 
arhe Peroxide; marked the cotton and sent the same to him. 

He reported the best results from the peroxide and advised its continuance. 
Though it did not kill the sores it made them inactive, while no perceptible difference 
•could be seen upon them from the other two. This peroxide bore the initials P. &. W., 
our noted Philadelphia chemists. Seeing Marchand's advertisement in the Summary, 
I concluded to try his, and sent for some. He kindiy included in the order his glyco- 
-zone to use in conjunction with the peroxide. A marked change was the result. The 
«ore looked better, cleaner, healthier, and upon examination of the cotton, Dr. C. 
•wrote me to continue the use of Marchand's. Here was a decided test and in favor of 
Ch. Marchand's. The ulcer has steadily progressed for the better. * * * * 



HYDROGEN DIOXIDE; A RESUME. 
» By JOHN AULDE, M. 1)., Philadelphia. 

JMember of the American Medical Association, of the Medical Society of the State of 
Pennsylvania, of the Philadelphia County Medical Society, etc. 

(Published by the New York Medical /ourual, December 27, 1890.) 

Within the past ten years the use of hydrogen dioxide (Peroxide of Hydrogen) has 
Ibecome quite general among practitioners whose business has led them to give special 
attention to some particular class of disorders. Many general practitioners, however, 
. ihave not availed themselves of the benefit afforded by this comparatively recent addition 
to our therapeutic resources, owing to the expense and the care required in looking 
.after details, together with the uncertainty which attended its employment. These 
"difficulties no longer exist; but, when we consider the advantages to be gained from its 
^tise, the process of evolution has been remarkably slow, notwithstanding the sporadic 
•attempts which have been made to attract the attention of the medical profession. 
Novel methods of treatment are too frequently shunned without investigation by 
regular physicians, while, on the contrary, these innovations are readily adopted to 
the wants of the quack. 

In the present instance, although the furore for antiseptics continues unabated, 
the true position of oxygen has been ignored by those who should have given it their 
first attention. Long-continued and persistent effort has erected an imposing- 
superstructure upon a theoretrical foundation, losing sight of the marvelous influences 
constantly at work in nature. The corner-stone of this ornate edifice originally 
adopted was carbolic acid; the pilasters which gave strenpth and beauty to its walls 
•were composed of carbolated gauze, while cornice and roof were made of protective 
•which had been submitted to a carbolizing process. This highly flavored substance 
lias given place to a number of others, some of which are safer, but no more useful; 
-sotlrers are more efficient than carbolic acid, but, as usually employed, are far more 
•dangerous. As the foundation for asepsis rests upon absolute cleanliness, so the 
foundation for antisepsis must rest upon an equally safe basis as regards the patient. 



77 

The only agent known at the present time which fully meets our requirements isr 
oxygen in some of its forms. While the spores of anthrax bacilli resists our most 
poisonous products — such as solutions of hydrochloric acid (two per cent.), boric an<£ 
salicylic acids in concentrated solutions — oxygenated water alone, in sufficient quantity 
was shown by Paul Bert and Regnard to possess the power of destroying the bacteria. 

The wonderful properties of ozone are but partially understood; like some other 
powerful agents, it cannot be safely handled, but it gives great promise of usefulness: 
in the future. The statement has been made that ozone is but an allotropic form of 
oxygen, and that it is identical with hydrogen dioxide (the subject of the present 
article,) and for all practical purposes, from a therapeutic standpoint, they may be 
considered substantially the same. Having, then, at our command a remedy- 
possessing such remarkable properties as a bactericide, one which is perfectly harmless- 
when brought into contact with healthy tissues, it will be worth while to study the 
indications for its use in the treatment of disease. In the first place, however, I 
should say a word with reference to the causes which have contributed to prevent its 
universal employment by physicians — causes already referred to incidentally. * * * 

3. The uncertainty following the employment of the peroxide has arisen fronr 
various causes, and, as this is a subject of paramount importance, the items will be 
considered in detail. In the pure state hydrogen peroxide is exceedingly unstable^ 
and, in order to render it less susceptible to the action of heat, which causes it to part: 
with nascent oxygen rapidly, minute quantities of hydrochloric and phosphoric acids are 
added to the usual fifteen-volume solution; but this, instead of retarding, rathec- 
heightens the effect of the remedy when applied to unhealthy structures, especially 
mucous surfaces. When the container is allowed to remain in a warm room, or wherr . 
it is not properly stoppered, the activity of the preparation is materially lessened, i£ 
not entirely lost. An excess of acid is objectionable, however, as it renders the : 
peroxide irritating instead of soothing. 

Commercial peroxide which is used extensively for bleaching purposes and in the ■ 
arts, is doubtless responsible for unsatisfactory results, but, as compared with the 
medicinal preparation, it is a very inferior product, sold at a cost of about eight cents- 
a pound. Physicians should know that this product always contains a large proportion 
of acids (two to five percent.), hydrofluoric, sulphuric, hydrochloric, oxalic, and nitricr 
acids, and, knowing this to be the case, they should be careful to examine the 
reactions and see that the medicinal preparation obtained by patients is supplied irt 
original packages. The commercial product is not "just as good" nor will it "do as 
well" for the patient; and if these suggestions are kept in view, the success of the 
peroxide is assured. 

Another important thing which I have learned is, that the mixture of the peroxide 
with glycerine does not make "glycozone," but, instead, a mixture which generates 
slowly but constantly secondary products, which appear to possess irritating properties 
almost as toxic as those of formic acid, well known in Central Africa as a deadly 
arrow poison. I am of the opinion also that when the peroxide is used in the form of 
an inhalation by heating with water, a considerable proportion of the nascent oxygen is 
transformed into ordinary oxygen before reaching the affected tissues, and while I can 
readily understand how this must detract from its efficiency, remarkably prompt results 
have attended its administration in this manner. The only obstacle in the way of 
securing immediate and favorable results from the exhibition of this agent is our 
inability to command at all times a freshly prepared and thoroughly reliable product, 
free from the impurities incident to its manufacture; but that difficulty, I believe, is 
no longer an excuse, as it can be supplied by the principle druggists throughout the 
country. * * * 

Therapeutics — From the Peroxide of Hydrogen we may obtain, in the form of a 
vapor or spray, the therapeutic effects of nascent oxygen, and as a surgical application 
or antioacterial substance this product is far superior to the gas itself. Used in the 
form of a vapor by inhalation, it increases the secondary assimilation by favoring the 



78 

elimination of excrementitious products through the stimulating effect upon internal 
respiration. Just as pure mountain air arouses the activity of functions which have 
been depressed and promotes health, so oxygen evolved in this manner increases tissue 
change and prevents the suboxidation which attends upon the arrest of cell function. 
Oxygen is a tissue builder as well as an oxidizer of carbonaceous and excrementitious 
products. When it is introduced into the alimen ary tract, abdominal fermentations 
are arrested by the destruction of the germs which produce them; unhealthy mucous 
secretions are destroyed, while the vitality of the cells lining the walls of the intestine 
is augmented, and their power against the absorption of ptomaines and leucomaines 
greatly increased. The surgeon will find the peroxide an efficient and most convenient 
antiseptic, as it can be freely used in cavities, in discharging sinuses, and upon the 
most delicate tissues, without danger of producing the slightest irritation. In all 
cases of threatened collapse, in low conditions of the system, and during convalescence 
from severe illness, the physician should bear in mind the wonderful revitalizing 
properties of this remedy. Perhaps the reader will gain a more practical idea of the 
applications by a reference to some of the more prominent indications, and I shall 
briefly pass in review some of the diseases in which, it may be used with beneficial 
results. * * * 

.Since it has been determined that in yellow fever and cholera the poison germ is 
found only in the intestine, the peroxide promises to afford exceptional relief in these 
diseases. When it is introduced into the rectum, the heat of the body will cause 
oxygen gas to be evolved, while the local action of the drug will destroy all unhealthy 
products which may be present in the lower bowel. The nascent oxygen will be taken 
up by the absorbent structures and enter the general circulation; but if we accept the 
doctrine of phagocytosis, it will do even more than this, by reason of its stimulating 
action upon the modified white corpuscles, which are now regarded as the special 
enemies of bacteria escaping through the walls of the intestines. And for the same 
reason it may be used with advantage as a lavement in the treatment of diarrhaa, 
dysentery, and in typhoid fever. In the latter disease I have used the pure oxygen 
gas with very great satisfaction, and have found a solution of the peroxide superior as 
a mouth wash during the progress of the most tedious disorder. 

The peroxide should be used in all forms of indigestion, and more especially when 
the stomach is weak and depressed to such an extent that the usual antiseptics are not 
well tolerated. Those who use it once for the relief of indigestion, gastritis, gastralgia, 
and the arrest of fermentation, or an abnormal flow of mucous, will have no cause 
to regret the selection. A large number of cutan-cons affections are dependent upon an 
unhealthy condition of the alimentary tract, such as urticaria, eczema, etc., and, of 
course, are benefited by the use of the peroxide. 

Pulmonary affections have long claimed the attention of those who dabbled 
with oxygen inhalations, and it is in this class of cases where faithful attention to 
details will produce most marked effects, although I can not be convinced that any 
medicament in itself can arrest the progress of the disease. The continued use of the 
peroxide internally improves the primary assimilation; the regular and systematic 
inhalation of the vapor will not only improve the secondary assimilation, but will also 
destroy any morbid products with which it comes into contact in the pulmonary tissues, 
and, judging from my own experience with this agent, I have no hesitancy in saying 
that its value is not yet appreciated by a large number of physicians who, with it, 
might be the means of prolonging human life. My observations with the vapor and 
spray in astJunatic conditions have been surprising, and I have found them of signal 
service in meeting emergencies, such as asphyxia from coal gas, sudden collapse from 
hemorrhage, typhoid and other fevers. The long continued use of the vapor has a 
marked effect in restoring the resiliency of the air-vesicles in emphysema when it 
occurs along with asthma in young persons. A gentleman now under treatment has 
suffered from asthma since he was six w r eeks old, and is now twenty-five, but under 
this treatment he has gained weight, is able to sleep regularly every night, and has 



79 

increased sixteen pounds in weight during the past three weeks, while the chest 
measurement has apparently decreased. This method of treatment is valuable in 
phthisis at all stages, but it should be used as an adjuvant to other treatment and 
attention given to diet. In this connection should be mentioned the usefulness of the 
vapor in the treatment of bronchitis, subacute and chronic, and at the same time the 
value in aborting attacks of acute catarrh. 

Inhalations of the vapor will prove useful as an adjuvant in neuralgia, amemic 
headaches, general debility, malarial toxaemia, and corpulence, combined with diet 
adapted to the various disorders mentioned. # 

In surgical practice, when the solution of the proper strength is brought into 
contact with diseased tissues, a brisk effervescence takes place and continues until all 
the pus corpuscles present are destroyed. The solution may be used topically in 
nearly all cases of catarrh of the upper air passages in the form of a spray, and it may 
be used as an antiseptic after the removal of pus in empyema. The substance 
possesses the advantage over other antiseptics of being harmless, and can therefore be 
used freely in diphtheria and croup. There are so many indications for its employment 
that it would be difficult to mention all the topical uses, although the following may be 
referred to, viz., boils, carbuncles, indolent ulcers, carcinoma, and venereal diseases 
.as an injection. 

The gynaecologist will find numerous applications for this agent. It may be used 
in the form of a douche in leucorrhcea, elytritis, vaginismus, and a cotton-wool 
tampon may be saturated with and placed in a gelatine capsule (veterinary size) and 
introduced into the vagina in the case of ulceration, vesico- vaginal fistula, and 
endometritis. The ophthalmologist and aurist will likewise find that it furnishes them 
the most complete and safe antiseptic that can be had, and gradually its employment 
will extend to every department of medicine and surgery. 

The most flattering commendations of "Marchand's Peroxide of Hydrogen 
(medicinal)" have been given voluntarily by numerous well-known authors and 
contributors to medical literature within the past few years, some of whom may be 
mentioned as additional evidence that the methods here recommended are worthy of 
further investigation: Dr. W. B. Clarke, of Indianapolis, Ind.; Dr. George B. Hope, 
Surgeon to the Metropolitan Throat Hospital, New York; Dr. J. Mount Bleyer, of 
New York; Dr. Robert T. Morris, of New York; Dr. Paul Gibier, Director of the 
New York Pasteur Institute; Dr. R. Charest, of St. Cloud, Minn.; Dr. E. R. 
Squibb, of Brooklyn, N. Y.; and others whose names cannot now be recalled. 
Dr. Morris refers to it as "the necessary Peroxide of Hydrogen", and I have found 
Marchand's product to possess in a remarkable degree the properties so essential to 
success — viz., uniformity in strength, purity, and stability. 



PEROXIDE OF HYDROGEN IN GYNECOLOGY AND IN 

OBSTETRICS. 
By EGBERT H. GRANDIN, M. 1). 

Obstetric Surgeon New York Maternity Hospital, Visiting Obtetrician Ne-.e York 

Infant Asylum, etc. 

(Published by The Times and Register , of Philadelphia, January 31, 1891.) 

Modern methods of antisepsis enable us in the vast proportion of cases to prevent 
suppuration. The problem remaining is how arrest it when present, or abort it when 
imminent. 

The virtues of peroxide of hydrogen (\l 2 Og) in general surgical practice have re- 
cently been heralded by Dr. Robert T. Morris, of this city, in the columns of The 



8o 

Times and Register* The object of the writer is to exemplify his personal experience 
with this agent, through the brief record of a few cases in which he has tested it. 

Case I. Sub-mammary abscess. — About one year ago I was consulted by a 

Mrs. G. She was nursing a two and a half months' puny infant, notwithstanding the 
fact that the right mamma was fairly riddled with sinuses, and the left presented to un- 
touch faint fluctuation. Her previous medical attendant had exhausted all routine 
measures, and yet, as she expressed it, "she was going from bad to worse." She had 
hectic fever and other symptoms of sepsis; her appearance suggested the absolute neces- 
sity of rapid action. 

1 at once weaned the child, of course; made a deep incision in the left mamma, 
giving exit to a mass of fetid pus, washed out the cavity with bichloride (1-1,000), and 
packed it with gauze. I thoroughly wetted the sinuses in the right mamma, irrigated 
and packed them similarly. In a few days I had control of the sepsis, but the pyogenic 
membrane and its product resisted all my efforts. In despair, and without much hope 
of success, I washed out the cavities with peroxide of hydrogen (half diluted with 
glycerine), and applied a compressed gauze bandage. At the end of ten days the 
abscesses were cured. 

Case II. Suppurating pelmc hematocele. — This case was seen in consultation. 

The patient was a young prostitute, and the only etiological cause I could determine 
was copulation during menstruation. The tumor bulged in the retro-uterine pouch, 
and I treated it as follows: Under antiseptic irrigation I aspirated along the finger 
as a guide, and obtained a mixture of blood and pus. Using the aspirator muzzle as 
a director, I enlarged the opening transversely, sufficiently to admit a Palmer dilator. 
Inserting this I divulsed, curetted the cavity — which measured fully three inches 
square — and washed it out with equal parts compound tincture of iodine and water. 
I next inserted a flange-rubber drain tube. The cavity was washed out daily through 
this tube with two and one-half per cent, carbolic, but contrary to my experience with 
similar cases, it had not contracted much at the end of a week, and was still secreting 
pus. I then inserted a small Chamberlain glass uterine tube, and distended the 
cavity with undiluted peroxide of hydrogen. This checked suppuration at once, and 
when the patient was seen three weeks thereafter, an induration in the posterior 
vaginal cul-de-sac was the only remnant of the hematocele. 

Case III. Puerperal septic endometritis. — Seen in consultation. Fifth day 

post-partum. Patient had foetid lochia, tenderness over uterus, rise of temperature, 
rapid pulse. A number of intra-uterine bichloride douches had been administered 
before I saw the case. Having differentiated extra-uterine source of the general 
sepsis, I curetted the cavity of the uterus, according to the method I have repeatedly 
described and advocated, removing a mass of degenerated decidual matter, and then, 
instead of applying pure phenic acid to the cavity, and irrigating it with iodine and 
water, I washed it out through a Chamberlain glass tube with a pint of peroxide of 
hydrogen (undiluted). The local sepsis was thus at once checked; the patient made 
a rapid convalescence under the means which suggest themselves for meeting the 
sepsis already in the sysetm. 

These cases typify instances in which the peroxide of hydrogen will be found use- 
ful by the gynecologist and obstetrician. As opportunity offers I propose to resort to 
this agent in vaginitis, urethritis and purulent cystitis. Further, and in this di- 
rection I am as yet only experimenting, I am hopeful that in this agent we will 
find we possess a means which will enable us to avoid laparotomy in certain instances 
of pyosalpinx. My conclusions on this point, however, it would be premature to state. 

My experience thus far with the peroxide of hydrogen justifies the statement that 
it is absolutely harmless, and that it is at the same time the most efficient of all the 
agents at present at our disposal for preventing the ravages which uncontrolled 
suppuration is capable of causing. 

* See p. 7 2, reprint of article headed "The Necessary Peroxide of Hydrogen,"' by Dr. Robert T. 
Morris. 



8i 

SINUS TREATED WITH PEROXIDE OF HYDROGEN. 

(Extract from Practice', Richmond, Va., February, 1891.) 

Dr. William F. Waugh tells in the Times-Register of an old woman who stepped 
on a nail, which penetrated the foot almost to the superior surface. A sinus formed, 
and had been discharging for two months when the patient was first seen. Marchand's 
peroxide of hydrogen was injected into the sinus by means of a hypodermic syringe. 
The first effect was to destroy the leather of the piston. The sinus was found to be 
of a horse shoe shape, the probe passing almost through the foot, between the meta- 
tarsal bones, and when the peroxide was injected a hard lump could be felt one inch 
from the opening on the sole of the foot. This was laid open, and a stream of pero- 
xide was sent throueh. Result: Cured in a week. 



DIPHTHERIA AND THE USE OF HYDROGEN DIOXIDE 
IN ITS TREATMENT. 

Read before tlie Chemical Society of Maryland, February 6, i8qi. 

By Dr. EDW. J. BERNSTEIN, Baltimore. 

(Extract from Maryland Medical Journal, February 21, 1891.) 

In this very elaborate paper, Dr. E. J. Bernstein says: (p. 361). . . In my 
first case of diphtheria I began the use of Sulphide of Calcium, but finding that not 
only was it disagreeable to both the taste and smell, and that it also soiled the bed linen 
and clothing of the patient, but that the patient continued to get worse, that the 
membrane which at first was limited to large necrotic patches on the tonsils, now 
covered the entire anterior pillars of the fauces and the uvula, which was now 
considerauly swollen. 

I discarded the nostrum and began the use of Hydrogen Dioxide, which I directed 
to be sprayed into the throat every hour of the day and night, gradually relaxing the 
number of night sprayings as the case went on to improvement. I also directed that 
the nose should be sprayed at least twice a day with the same solution. Within a few 
hours the mother said she noticed a change for the better in her child, and when I 
made my evening call it was quite perceptible. I also noticed, which fact I have since 
seen corroborated by others who had used the drug, the better color of the child. 
The lips, which before its administration were quite blue, were now 01 a healthy red 
color. The membrane in the throat had made no increase. By the following morning 
there was a decided decrease in the pseudo-membrane, and from now on began to dis- 
appear. 

In conjunction with the above local treatment, I gave large doses of tinct. ferri chlo. 
in combination with tonic dose of quinia every three hours. 

Cream of tartar lemonade was given ad libitum to appease thirst and to relieve con- 
gestion. The air of the room was regularly charged with steam, generated on a small 
alcohol stove, to which had been added an alcoholic solution of menthol, eucalyptol and 
thymol. It is well to say that the strength of the hydrogen dioxide was 50 per cent, of 
Ch. Marchand's 15-volume solution. 

In three other cases which came under my observation, I followed out the same line 
of treatment, and each recovered without any untoward after effects. In the hope that 
some of you here this evening may be induced to try this plan of treatment, I submit 
this paper. 



82 

HYDROGEN PEROXIDE IN DIPHTHERIA. 

By G. F. ADAMS, M. D., Pulaski, N. Y. 
(Published in the Medical Era of Chicago, 111., March, 1891.) 

The article in the December Era copied from the Medical Times, by Dr. George 
W. Major, in regard to the use of Peroxide of Plydrogen in diphtheria, I can heartily 
indorse. I have just discharged three cases of diphtheria that I treated with Ch. 
Marchand's Peroxide of Hydrogen. I sprayed the throat with an atomizer filled with 
full strength 15-volume solution of peroxide in the early stages. The membrane was 
removed almost at once, and after the first application and one complete clearing of the 
throat, I then reduced the 15-volume solution by adding three parts water to one of 
peroxide, and by spraying the throat thoroughly as often as once an hour, all membrane 
was destroyed, the breath was kept sweet, and the throat in a fairly comfortable condi- 
tion. When used at first in full strength the patient may complain of a slight smart- 
ing, but no irritation results. 

The atomizer should consist of nothing but glass and rubber, as the peroxide has 
a strong affinity for all metals, except gold, silver, and the rare metals. 

I can assure all who try Peroxide of Hydrogen as a local application in diphtheria 
that they will be thoroughly well pleased with it. 



SCARLATINAL DIPHTHERIA. 

By WM. F. WAUGH, M. D. 

(Extract from The Times and Register , Philadelphia, March, 7, 1891.) 

I desire to place upon record a case that is unique in my own experience; though 
my readers may, perhaps, have the better results. The case was that of a child under 
four years of age. He had been attended by a dispensary physician during the first 
part of the illness; and this gentleman, when he gave up the case, had given a gloomy 
prognosis, with which I heartily coincided. On my first visit I found thechild's throat 
covered with blackish sloughs, the lips and tongue covered with fissures and ulcers, the 
nose discharging freely the irritating and offensive secretions of nasal diphtheria, the 
eyes showing spots of pus at the inner canthus. The child complained of earache and 
of pain in the forehead, so that the disease had'passed up the Eustachian tubes and into 
the frontal sinuses. Reddish spots and blotches appeared on the face and body. The 
stench was dreadful, the urine totally suppressed, but the few drops that were passed 
could not be saved for examination. The child had been delirious for some time, not 
being able to recognize his parents. The one good point was that his stomach retained 
milk fairly well. 

It has not been my good fortune to witness the recovery of many such cases. In 
fact, the more extended is my experience with diphtheria, the more I dread it; especially 
when it has become firmly established in the Schneiderian mucous membrane, and in the 
passage leading from the naso-pharynx. 

I felt it my duty to inform the parents that death was the only result to be expected; 
and that they could be very thankful if their other children, six in number, should escape. 

However, I gave them a bottle of Marchand's Peroxide of Hydrogen, and directed 
them to syringe the nostrils and wash the mouth out with a solution diluted to one-fourth 
its strength. This was repeated every hour, day and night. No other treatment was 
employed, and whiskey was given with the milk, as the only food. The child began at 
once to improve; the right tympanic membrane gave way, and then the solution was 



83 

thrown into the ear, and bubbled out at the nose. The urine began to be secreted more 
freely, and the child was pronounced out of danger one week from my first visit. 

One of the other children was seized with sore throat, enlarged tonsils and torticollis; 
another had a mild attack of scarlatina, but the others escaped without contracting the 
disease. This in itself is notable, as the children were all kept at home, in a crowded 
little house, with miserable sanitation. 



THE PEROXIDE OF HYDROGEN— ITS USES IN 
ABDOMINAL SURGERY. 
By CHARLES P. NOBLE, M. D., 

Surgeon-in-Chief of the Koisington Hospital for Women, Philadelphia. 
(Published by Philadelphia Medical News, April li, 1891.) 

The importance of the Peroxide of Hydrogen as a germicide, and more especially 
as a pus-destroying agent, is becoming firmly established by rapidly accumulating clinical 
evidence. A very considerable experience with the drug has made me enthusiastic con- 
cerning its remarkable qualities; and I find myself extending its application almost daily. 
In general, in order that antiseptic or germicidal agents may be used effectively, it is 
absolutely essential that all foreign material, discharges, etc., be first removed, so that 
the agent may be brought in direct contact with the surface or tissue to be acted upon. 
It is also true that the power of penetration of the antiseptics in common use is slight, 
so that they are reliable only in combatting strictly superficial septic processes. This is 
particularly true of corrosive sublimate solution, which, by its action on albuminous dis- 
charges, forms an impenetrable covering which prevents the solution from coming in 
contact with the tissues to be acted upon. In this respect the action of the peroxide 
solution is essentially different. It attacks, disintegrates and oxidizes all discharges and 
dead tissue with which it comes in contact, thus favoring its contact with and action 
upon underlying tissues. Moreover, the products of its activity escape as water and 
carbonic acid gas. At this time I do not propose to discuss the relative value of the 
Peroxide of Hydrogen as a germicide. I believe that our knowledge upon that subject 
will be far more exact after a little time than it is at present. The fact, however, that 
this agent has the power to oxidize dead organic matters suggests to my mind a wide 
field of usefulness for it in preventing saprsemia or ptomaine poisoning, in the treatment 
of suppurating tracks and cavities in which dependent drainage cannot be had, and in 
which free irrigation with water is impracticable 

In my work in abdominal surgery I have found Peroxide of Hydrogen of positive 
value. 

In cleaning the hands preparatory to operation I have found it very useful, 
especially when the skin around the finger-nails has become somewhat horny or rough- 
ened from too much use, or from frequent washings, or from prolonged contact with 
antiseptic solutions. Its power to loosen and to remove dead epithelial cells, and to 
soften the skin about the nails, is quite remarkable. Moreover, all foreign material 
about the nails is either oxidized and removed or it is made more accessible to the 
sublimate solution which is used later. In practice I have used the peroxide after 
scrubbing my hands through three waters with soap and the nail-brush, then soaking 
them in turn in saturated solutions of permanganate of potassium and of oxalic acid, 
and before soaking them in corrosive sublimate solution. 

Bacteriological examinations have shown that even this method (omitting the 
peroxide solution) does not make asepsis certain, as germs have been removed from^ 
the subunguial spaces after it has been faithfully carried out. I have not been able to 



8 4 

test the value of the addition of the peroxide of hydrogen solution in securing- asepsis 
by bacteriological experiments, but practically I feel convinced that it is of service in 
securing that end. The settlement of the question authoritatively will be of great 
interest to all those who believe in satisfying an antiseptic conscience. 

In the management of the drainage-tube after abdominal section, under special 
conditions, the peroxide solution has been of signal service. In typical cases, in which 
the drainage-tube is removed after from one to three days, there is no indication for its 
use. But when from any cause the drainage-tube must remain in longer; it is useful 
in keeping the tube and drainage track sweet and free from pus. On a number of 
occasions after a tube had been in a place from a week to ten days, and the discharge 
has become slightly purulent, I have been able to combat successfully the tendency to 
suppuration, to shorten the tube gradually, finally to institute a gauze plug for the 
glass tube, and to secure rapid healing of the drainage track; when otherwise a sinus 
would have resulted. One such case was one of a ruptured large ovarian tumor, 
having contents of a jelly-like consistency, which had become distributed throughout 
the peritoneal cavity. Jelly-like material was discharged through the tube for two 
weeks, and yet by the use of the peroxide solution rapid healing was obtained. 
Another case was one of post-operative intra-peritoneal hemorrhage. Tarry blood 
was discharged through the tube for ten days, yet the same care secured the same 
result. Another striking case was one of frecal fistula which formed after the removal 
cf a dermoid ovarian cyst — presumably caused by the growth of a small bunch of hair 
from the cyst into the bowel. The track was kept clean and the peroxide was used 
freely. The fcecal fistula closed in three weeks, and the remaining sinus closed within 
two months from the date of the operation, being kept open for a time by an infected 
omental ligature, and closing promptly after its discharge. 

The peroxide solution has been applied to the drainage track and to the inside of 
the tube by saturating absorbent cotton, held in a slender long-handled forceps, and 
passing this down the tube. The peroxide solution has been used pure or diluted (one 
to two or three.) 

I have not used the peroxide solution within the peritoneal cavity during opera- 
tion, but believe it will prove useful in disinfecting infected pedicles. In removing 
pus sacs rupture frequently occurs, deluging the broad ligaments with pus. Under 
these circumstances the ligature applied to secure the pedicle necessarily becomes 
infected. Heretofore I have washed away septic material with boiled water, and 
later applied bichloride solution on a sponge to the region of the ligature. In such 
cases it seems probable that the peroxide solution will be of real value. 

In cleaning the abdominal wound preparatory to removing the sutures, the 
peroxide solution has proven very efficient; especially if a dry dressing — boric acid or 
iodoform — has been used. Finally, if any pus has formed in the track of the drainage- 
tube or any of the sutures, the peroxide solution will remove it more efficiently than 
any other agent. 



A RESUME OF THE HISTORY AND PRACTICAL APPLI- 
CATION OF HYDROGEN PEROXIDE IN SURGICAL 
AFFECTIONS. 

By S. POTTS EAGLETON, M. D. 

Resident Physician in the Children s Hospital, Philadelphia. 

{Medical and Surgical Reporter of Philadelphia, May 16, 1891.) 

Hydrogen peroxide was discovered by M. Thenard, a French chemist, in the year 
1 8 18, since which time it has, like many other therapeutical remedies, lain dormant, 
occasionally being brought forward by some "enthusiast" and its virtues highlv 



«5 

extolled for a time. But the drug, unequal to the task of proving all that had been 
said in its favor, was again and again returned to its stall of oblivion. Within the past 
few years, it has been brought before the medical profession, on account of its 
antiseptic properties, and apparently has awakened into active therapeutic life. 

In looking over the literature on the subject, I find that Dr. B. W. Richardson,* 
in 1862, called attention to the action of hydrogen peroxide in an article upon the 
subject, which excited widespread interest in the profession at that time and has led 
to many experiments with the drug, both in surgery and medicine. 

It is my purpose to confine myself in this study entirely to the treatment of 
surgical affections. Before referring to the results of my own experience, during the 
past few months, I will briefly allude to some of the most important monographs which 
have appeared from time to time in our medical journals. C. T. Kingzettf believes 
that the substance exhibits striking antiseptic effects and is capable, even in very small 
quantities, of arresting the so-called process of fermentation which is originated by 
living organisms. He further calls attention to the fact that care should be exercised 
in making the solution neutral before using, and yet admits that neutral solutions are 
by no means as stable as those of a slightly acid reaction. In closing his 
monograph he states that the expectations of several noted surgeons of France in the 
treatment of wounds with this compound have been amply realized; among those 
may be mentioned M. Baldy, M. Regnard and M. Beau. In summing up his article 
he futher says that, in his opinion, hydrogen peroxide is far superior to phenol, and 
that it has been demonstrated beyond question that all wounds treated with peroxide 
of hydrogen have progressed well, healing generally by first intention. 

A. E. Prince:}: speaks most favorable of the results obtained with this remedy. 

C. E. Shelley§ considers it to possess anaesthetic properties, and at the same time 
claiming for the drug, not only a pus destroyer, but that it is an actual stimulant to the 
surface of wounds. To the carefully conducted experiments of Dr. P. Miquel, quoted 
by W, D. Bizett,|| we owe the establishment, on a firm basis, of hydrogen peroxide as 
a positive germicide. The line of experimentation pursued had the following aim: to 
-determine the quantity of various substances, commonly used as germicides, which, 
added to a quart of beef tea, would prevent decomposition. Miquel found among a 
long list of substances used by him, that only two were more powerful than hydrogen 
peroxide. The following table shows the relative strength, according to his experi- 
ments, of the four most powerful germicides: 

Biniodide Mercury 0.025 grains. 

Biniodide Silver 0.03 grains. 

Hydrogen Peroxide 0.05 grains. 

Bichloride Mercury 0.07 grains. 

The results thus obtained place hydrogen peroxide ahead of bichloride mercury 
as a germicide, with the advantage, also, of being absolutely void of any toxic action, 
while the corrosive sublimate is a most virulent poison. Bizett^" claims that when the 
pure peroxide, which is syrupy in appearance, is brought into contact with living 
tissues, it acts as a direct caustic. Various experiments were made by H. Gifford** 
directly with the disease germs, thus testing the germicidal action of the peroxide. 
Two methods of determining its ability to destroy germs, were used, that of Koch, and 
his own well-known method. The preparation of peroxide used, was that of Chas. 
Marchand's (15 vol.). Gifford found that the white and yellow cocci, as well as the 
bacilli anthrax, were killed in exposures of from £ to \\ minutes, It required but f of a 
.minute to destroy fully developed anthrax spores. He further found that the solution 

*B. W. Richardson, Tr. M. Loc. Lond., 1862, vol. II, pp. 51-53. 

*Ibid. 

tA. E. Prince, St. Louis, M. and S. Journal, 1884, vol. XLVI, pp. 246-252. 

§C. E. Shelley, Practitioner, Lond., 1884, vol. XXXII, p. 196. 

HW. D. Bizett, Atlanta M. and S. Journal, 1888-9, N - S. 

1 W. D. Bizett, Atlanta M. and S. Journal, 1888-9, N. S. 

** G. Gifford, Med. Rec, N. Y., 1888, Vol. XXXIV, p. 243. 



86 

exposed for 40 days, to a temperature of 68-75° killed the yellow pus cocci in from 
10-11 minutes. The same solution of peroxide, when diluted with. /our times its bulk, 
requires an exposure of 30 minutes to kill the pus cocci. If diluted with an equal 
volume, it kills within f minute. After an experience of six months, I. N. Love* 
sums up the action of hydrogen peroxide as follows: It is a most efficient means of 
cleansing purulent surfaces, deep cavities and sinuses, stimulating the healthy process 
in ulcerating parts. As a destroyer of microbes, a cleanser and securer of comfort, it is 
of great value as a local application. 

My own experience with this drug in surgical affections, during the past ten 
months; has been most satisfactory. During that time I have used the remedy in the 
following affections: Abscesses (acute and chronic, of various kinds), suppurating 
glands, sloughing gangrenous wounds, empyema of the chest, necrosis (general and 
localized), suppurative otitis media, and wounds of all descriptions. The ages of the 
cases treated, varied from two to thirteen years. The mode of applying the peroxide 
was as follows: All cavities, crevices, etc., were syringed with the bichloride of 
mercury (1-2000, to 1-6000) and then carefully cleansed with the hydrogen peroxide 
(Marchand's). > 

At first one volume of this solution was diluted with two to three times its bulk. 
Later on, I used the full strength. The first effect noticed after applying the 
peroxide, was the rapid oxidation of all purulent or bloody material, which would 
cause the distension of crevices, no matter how minute, with the oxygen, which was 
eliminated as a frothy (often yellowish, depending upon the quantity of pus present) 
bubbling substance. After the oxidation was completed, the wound was always left 
in a clean, sweet condition, absolutely free from pus. The wounds were then gently 
dusted over with iodoform and the usual antiseptic dressings of gauze, etc., were 
applied. On removal of the dressings, a few days later, it was noticed that the 
wounds were in almost every instance cleaner (especially marked in acute cases), more 
healthy in appearance and with a decided diminution in the quantity of pus secreted. 
The thought being suggested, that possibly the bichloride and not the peroxide was 
instrumental in producing the favorable results noticed, I commenced a series of 
control experiments. I would, at one dressing, use simply the bichloride of mercury, 
following this, at the next dressing, with the peroxide. Thus making actual 
comparisons in the same cases. Afier several alternate dressings as above, I found 
without exception that the hydrogen peroxide perceptibly diminished pus formation to 
a much greater degree than simply the bichloride alone. 

The belief that iodoform should not be used in conjunction with the peroxide, for 
fear of liberating free iodine, which, as a direct irritant, would defeat the object in 
view, is, I believe, erroneous. I found that when a quantity of iodoform was placed 
in a small receptacle covered with the peroxide solution and then set aside for periods 
varying from three hours to three days, on being treated chemically for free iodine; 
with the ordinary starch test, gave negative results. Although one drop of a solution 
of iodine, on being added to the same solutions, gave a brilliant reaction on addition of 
the starch. 

In all cases in which the peroxide was given a fair trial, I have observed a direct 
healing effect upon the granulating tissues. It is therefore evident that, owing to its 
oxidizing action on the pus and the diminution of the purulent secretions after its use, 
it does, either directly or indirectly, cause a destruction of the anthrax bacillus. In 
concluding my article, I think, from the chemical as well as the experimental evidence 
which has been deduced, we can safely sum up the action of peroxide of hydrogen in 
the treatment of surgical affections, as follows: 

1. Hydrogen peroxide is a positive germicide and a possible stimulant to 
granulating tissues. 

2. Owing to its especial property of eliminating oxygen, it is of unparalleled value 

* I. N. Love, Phila. Med. Times, 1887-1888, Vol. XVIII, pp. 362-364. 



§7 

in the distension of suppurating sinuses and cavities, especially in the mastoid region, 
or where it is almost impossible to reach unhealthy surfaces by other means. 

3. The diluted solution is perfectly harmless and can with safety be used in any 
quantity. 

4. The strong concentrated solution, syrupy in consistence, is a direct irritant to 
all tissues and should never be used. 

5. It possesses healing and cleansing qualities as well as those germicidal in 
nature. 

6. When exposed to light it loses strength; care should therefore be exercised in 
keeping the bottles well stoppered with rubber corks, and in a cool, dry place. 

7. Fibrin, cellular tissue and some metals, instantly decompose it. In contact 
with sugar and starch it eliminates carbon dioxide (C0 2 ). 

S. In washing suppurating surfaces, it should be used until oxidation ceases, 
thus showing a complete destruction of all existing purulent material.* 



EXTRACT FROM PAPER ON "ADJUVANTS OR AIDS TO 
GYNAECOLOGY— NEITHER MEDICAL NOR SURGICAL." 

By C. A. PHILLIPS, M. D., Boston, Mass. 

Read before the International College of Homoeopathy, held at Atlantic City, June 

19, 1891. 

. . . Another local application of great service in the treatment of gonorrhceal 
or syphilitic and all ulcerative conditions of the genital organs is Marchand's Peroxide 
of Hydrogen. While its power to destroy germs and septic matter with which it comes 
in contact is unsurpassed by any other germicide or antiseptic, it is perfectly harmless 
to living tissues. With a swab of cotton saturated with this solution the parts can be 
more thoroughly cleansed than by any other means with which I am acquainted, — thus 
removing effete poisonous or septic matter, and I cannot understand wherein this is 
any more objectionable than cleansing the skin with soap and water, or the teeth with 
a brush. 



MEDICINAL PEROXIDE OF HYDROGEN AND GLYCOZONE. 

By Dr. J. H. DeWOLF, Baltimore, Md. 
{The Southern Medical and Surgical World, of Baltimore, Md., August, 1 891.) 

The topical application of Oxygen is capable of immense benefit. In the pitting 
of Small-pox I most earnestly advocate and urge its use, either in the form of 
Glycozone or properly diluted Marchand's Peroxide of Hydrogen (Medicinal). I 
believe much deformity can be obviated by its use, and the force of the disease 
lessened. Foul and indolent ulcers, when treated by iodoform, carbolic acid, etc., 
are apt to poison the patients; such cases have occurred. With oxygen that would 
be impossible. In large suppurating sores, where the various germicides are dangerous 
on account of the large breach of continuity and absorption of the poison, the topical 
application of oxygen is perfectly safe, and to say the least, equally efficacious. 

Ophthalmia is advantageously treated by the topical application of either the Peroxide 
or Glycozone. Styes can be aborted if Glycozone be rubbed on the lids at the commence- 
ment; and as styes are painful, and swelling and pain last for a few days, the use of 

(Read before the D. Hayes Agnew Surgical Society of the undergraduates of the Medical Depart- 
ment of the University of Pa., February, 1891.) 



88 

Glycozone is satisfactory to both patient and physician. In nasal catarrh, when the 
mucous membrane is dry and crusts form, prompt and more satisfactorily results can 
be obtained from Glycozone than from any other means known. 

In the various chronic inflammations of the throat which are ordinarily obstinate to 
treatment, I have frequently satisfactorily treated by the Peroxide (diluted,) especially 
when the orifice of the eustachian tube was closed by swelling, and the patient rendered 
uncomfortable by temporary deafness and ringing in the ears. 



PEROXIDE OF HYDROGEN, MATERIA MEDICA AND 
THERAPEUTICS. 

Vol. II, Page 681, 1891. 

By JOHN V. SHOEMAKER, A. M., M. D. 

Professor of Materia Medica, in the Medico Chirurgical College, of Philadelphia, Pa 

Pharmacology. — The usual strength of peroxide of hydrogen is called the fifteen- 
volume solution, because each portion of the solution yields fifteen volumes of the 
oxygen. It is prepared by Charles Marchand, New York, for medical use, and is an 
active oxidizing and antiseptic agent. Glycozone is the trade name of a similar 
preparation in which glycerine is the vehicle. 

THERArY. — Though less powerful than many other antiseptics, the solution of 
hydrogen peroxide has a special place in surgery, gynecology, and obstetrics, on account 
of its powers of decomposing pus and destroying the microbes of suppuration. Being 
free from all irritating, qualities, it can be poured over wounds, injected into sinuses, or 
into the ear, or used as a spray in ulceration of the pharynx and of the larynx. 

It produces a frothing up when it encounters pus, owing to the liberation of oxygen, 
and the cessation of this commotion indicates the removal of all pus. The surface of 
the wound or ulcer becomes blanched, but is not injured by the application. 

Tubercular and mammary abscesses especially are well treated in this way. In 
ulcerative tonsilitis, fetid breath, and in some bronchial affections, a spray of dilute 
hydrogen peroxide is productive of benefit. A spray of this agent is likewise of utility 
in chronic nasal catarrh, ozcena, and scarlatinal angina. It has been administered, well 
diluted, in gastric affections, and is said to be very useful in flatulent dyspepsia, heart- 
burn, catarrh of the stomach and bowels, etc. 

In diphtheria and croup its value has been established; a two volume solution is 
especially recommended in young children as a local application, and particularly after 
separation of the membranes, in order to remove the odor and disinfect the surface. 
Internally it is too quickly decomposed in the stomach to render much service as a 
source of oxygen to the blood. It might prove of value in gastric ulcer. 



PEROXIDE OF HYDROGEN IN DISEASES OF THE 

MUCOUS AND SEROUS MEMBRANES. 

By W. S. MULLINS, M. D., Henderson, Ky. 

A paper read before the International Homcepathic Congress, Atlantic City, N. J, 

June 16-23, 1891. 
(Published by the Medical Era of Chicago, November, 1891.) 

Since the discovery of Peroxide of Hydrogen in 1818 by the French chemist, 
Thenard, and its introduction to the medical prof ession by Richardson, in 1858, it has, 
like most remedial agencies brought forth by the empirical school of medicine, enjoyed 
great favor for a few years, only to fall into disuse, not because it did not possess virtues 
peculiar to itself, but from the fact that it was an impure chemical substance, producing 



8 9 

-escharotic effects when applied locally, and poisonous effects upon the system when 
diluted. 

What it may do outside of its remedial effects upon mucous and serous membranes, 
I know not. But the results obtained in diseases of the nose, throat, ear, skin and womb, 
I have had an extended clinical experience of ten years. It is Marchand's Peroxide of 
Hydrogen, H 2 Oo, that I speak. 

I know of no chemico-therapeutical substance of modern use, that brings the 
physician a more decided and powerful curative action, in its range of indications. 

Before entering into its chemical adaptation, permit me to say, by way of caution, 
that in no instance, and under no circumstances, should the commercial and poisonous 
Peroxide of Hydrogen be used. Neither should it be applied or inhaled except by means 
of glass, rubber, porcelain or gold instruments, as its effects are certainly contaminated, 
if not entirely destroyed, by any other appliances than the ones named. 

In acute, subacute or chronic cases of catarrh of the head, when accompanied by 
an acrid, excoriating discharge, and much sneezing, it will almost certainly control the 
sneezing and change the nature of the discharge from acrid to bland. 

In chronic nasal discharge, either from the anterior or posterior nares, of a yellowish 
greenish fetid character, with an accumulation of hardened pus and scabs in the nose, it 
will soften them and cleanse the nose effectually. 

In both conditions of nasal catarrh as enumerated to be followed by an application 
of glycozone on a cotton swab; or, better still, to saturate a small cotton tampon of 
borated cotton with the glycozone and place it well up each nostril ; allow it to remain 
from one to two hours, cautioning your patient to remove it gently and to desist from 
any forcible blowing of the nose between treatments. 

In granular pharyngitis, produced by smoking apply by means of a spray as follows: 
B, Peroxide of Hydrogen, 15 volumes, § ss. 
Aqua distillata, § ijss. 
To be followed by inhalations of ozonized vapor. It is a radical cure. Three 
sprayings and three inhalations in bad cases, and once a day in simple cases, should be 
used cautioning your patient to hawk as little as possible. 

In diphtheria, an early application of copious and frequent spraying of the nose, 
mouth, throat, pharynx and larynx, administered with a mixture of: 

B; Peroxide of Hydrogen, 15 volumes, § ss. 
Aqua distillata, ^ iij. 
When diphtheria is well developed, irrigate copiously and frequently, the nostrils, 
pharynx, mouth and larynx, with a stronger mixture as follows: 

B, Peroxide of Hydrogen, 15 volumes, ^ jss. 
Aqua distillata, § ss. 
The above is the best local application for this most dread disease. It is to be used 
of course with the indicated internal remedies. 

In bronchitis and asthma, administer ozonized vapor inhalations three or four times 
a day with a solution made as follows: 

B, Peroxide of Hydrogen, 15 volumes, § iss. 
Glycerine, § j. 
Koch's lymph or Shurley-Gibbes iodine, chloride of gold and sodium, are nowhere 
in benefiting your consumptive patients, when compared with the following: 
B^ Peroxide of Hydrogen, 15 volumes, § ij. 
Pure glycerine, § j. 
M. Sig. Shake well, inhale for ten minutes, four times per day, in alternation 



with the following: 



Fl. ext. Hydrastis, § ss. 
Glycerine, ^ j. 
Kreasotum, m vj. 
Aqua distillata, ^ jss. 
M. Sig. As directed. 



9° 

In cases of the many different varieties of eruption seen so often upon the faces of 
young girls from 15 to 23 years of age, including blackheads, by applying first for 
about three minutes, to the face, a flannel cloth as hot as can be, wrung out of hot 
water, then apply by means of a sponge Marchand's full strength Peroxide of Hydrogen, 
followed by rubbing well into the skin, boracic acid; one to three applications per day, 
according to the severity of the case, will give you all the reputation you desire as a 
dermatologist. 

CONJUNCTIVITIS. — The following makes a splendid application for catarrhal 
or granulated conjunctivitis: 

Py Glycerine, § j. 
Boracic acid, § j. 

Mix well in a mortar and add Peroxide of Hydrogen, \ j. Apply by means of a 
camel's hair brush. Keep well corked. 

CHRONIC ULCER. — I have just dismissed from my office, cured, an old chronic 
ulcer of the leg of fifteen years' duration. It was one inch deep, three inches long and 
two inches wide. 

The only treatment the patient received was the application of Peroxide of Hydrogen, 
15 volumes, dropped on carefully night and morning by an ordinary glass dropper, 
being careful not to disturb the white foam thereon. The whole was then covered by 
borated cotton, saturated with glycozone, oil silk over this, the leg kept bandaged from 
the foot to the knee by an Empire elastic bandage — by the way, far superior to Martin's. 

During the three months he was under my treatment, he received three doses of 
sulphur, 47m, ten doses of Arsenicum, 3x, ten doses of Argentum nit., 6 X , ten doses 
of Lachesis, 6 X , ten doses Calcarea sulph., 6 X , which, in my mind, contributed much to 
curing the case. 

GYNECOLOGY. — In the field of gynecological work, nothing serves me as well 
and often, nor is there anything in my opinion, fo take its place. 

ABSCESS OF THE LABIA. — Puncture with bistoury, cleanse with pure Peroxide 
of Hydrogen, 15 volumes, then by hypodermic syringe inject slowly into the sac, 10 or 
15 drops of Glycozone; very little reaction follows, and the results are perfect. 

VAGINITIS. — As a vaginal douche, use hot buttermilk; then by aid of the 
speculum and a small cotton swab on an applicator, apply the pure Peroxide of 
Hydrogen, 15 volumes, to the entire mucous membrane, including the cervical canal, 
to be followed at once by an application of Glycozone. Insert into the vagina a roll of 
cotton saturated with Glycozone, which serves to keep the inflamed surfaces apart. Use 
the same treatment for vulvitis. 

ENDOMETRITIS. — In endometritis, when the discharge is white and acrid, or 
yellowish, greenish and fetid, apply full strength, 15 volumes, being careful not to wipe 
off the foam generated, follow by one application of a tampon, or tampons, saturated 
with Glycozone. 

CHRONIC METRITIS.— Copious hot water vaginal douches; then apply full 
strength, Peroxide of Hydrogen, 15 volumes, followed by tampons of Glycozone, applied 
every other day. This treatment is worth the consideration of any member of this 
institute. It is, of course, understood that in all cases the indicated remedy must be 
used, combined, in the judgment of the physician. 

In almost all cases where the Peroxide of Hydrogen is used in the nose or throat, it 
should be diluted one-third, one- fourth, one-half, three-fourths, and sometimes four- 
fifths, with pure distilled water. 

My rule has been, except in cases of nasal catarrh, accompanied with much sneez- 
ing and very acrid excoriating discharge, to use it just strong enough to produce a very 
slight tingling sensation. 

It should be borne in mind that, when used in the nasal cavities, it produces fre- 
quent sneezing, and if too excessive, should be diluted still more. If its use on irritated, 
inflamed or ulcerated surfaces should produce a too free discharge of blood, you may 
conclude that it needs further weakening. 



9 1 

If you desire a better, quicker and more effective local treatment for carbuncles^ 
than carbolic acid, in conjunction with your constitutional remedies, inject pure medicinal 
Peroxide of Hydrogen by use of hypodermic syringe; a keen, cutting, stinging pain 
follows. When the pain has subsided, inject by same means, a few drops of Glycozone. 
I am only sorry my time will not permit me to enter as fully as I would like in explana- 
tion of it's beneficial use, and speak of its great curative powers in eczematous vesicular 
eruptions, in vesicular erysipelas, in aphthous and cancerous conditions of the mouth 
and of its value as an internal remedy in gaseous dyspepsia that will not respond to 
Lycopodium, China, Argentum, Magnesium, Phosphorus or Carbo veg. 

As I have already indicated, I have great faith in the Peroxide of Hydrogen, in 
the treatment of consumption. Give inhalations on alternate days, of the Peroxide, and 
Hvdrastis, at the same time giving nourishing food, and attending to other conditions. 
It has helped me to cure several well-developed cases of consumption. The use of the 
Hydrastis is not original with me, but the plan of alternating the two I have never 
known to be used by others. 

I am loth to leave this, to me, interesting subject. I trust that it maybe of benefit. 
to you. 



WAX IN THE EARS. 

By A. S. TUCKLER, '92, C. M. C, S. F, 

(Published by the California Medical Journal, San Francisco, Cal. , June, 1892.) 

A simple method of removing "wax in the ears," is to take Peroxide of Hydrogen, 
(Marchand's), warm it in a water bath, then with an atomizer spray the meatus for 
about five minutes. This will soften and partially dissolve the cerumen. An ear spoon 
will now remove the mass, and to the surprise of the patient, the sense of hearing will 
be immediately restored. A little more of the spray to cleanse the parts will be all that 
is necessary. This is a far safer method than the digging-out process, and not liable to 
perforate tympanum, an experience which the writer has been subjected to. 



SOME PRACTICAL POINTS IN THERAPEUTICS. 

By JOHN A. LARRABEE, M. D. 

Professor of the Principles and Practice of Medicine, Hospital College of Medicine^. 

Louisville, Kentucky. 

(Abstract of paper read before the Louisville Medico-Chirurgical Society, Oct. 2, 1891.) 

Permit me, in conclusion, to make mention of those therapeutic agents which, 
during the summer months, have been weighed in my practice and have not been found 
wanting. In entero-colitic diarrhoea, the so-called "summer complaint" of cities, 
dependent upon the various micro-organisms, vitiated air, and bad food, salol, naphtha- 
line, carbolic acid (nascent), calomel in minute doses and nitrate of silver, have stood 
the test. In gastro-enteritis, I have found salicylate of bismuth useful, and in inflam- 
matory diarrhoea (the dysentery of some authors) of infants and older children, Rochelle 
or Epsom salts in acid infusion of roses with small doses of laudanum. In chronic 
cases the nitrous acid camphor mixture of Dr. Hope has not failed. For the gastric 
fevers so common in children, the preparations ammonia-phenique and sulpho-phenique 
of M. Declat have been used exclusively in a large number of cases with much better 



9 2 

^results than any former treatment; also the same for the exanthema. For "whoop- 
ing-cough," Declat's syrup coqueluche is nearly a specific. In diphtheria, locally, 
Marchand's Peroxide of Hydrogen and whiskey internally have established their value. 
A word in regard to the use of the peroxide. It should always be purchased in the 
smaller four-ounce bottles, protected from the light by blue glass bottles and corked 
with rubber. That sold by the druggists from large bottles is, in the majority of cases, 
worthless. It is a very unstable article, and unless it causes immediately a white, foamy 
reaction when brought into contact with the false membrane, it should be discarded and 
another lot obtained. I am satisfied that I use it more freely and more persistently than 
most practitioners. I use mops made by twisting a sort of absorbent cotton upon sticks, 
using as many as thirty or forty in the twenty-four hours. Such mops will take up 
nearly a half ounce apiece, and when forced well back into the pharynx reach all parts. 
The gagging and resistance of the child assists in the distribution of the fluid. As soon 
as a mop has been used it is committed to the fire. In this way I have treated the 
worst as well as the milder forms of diphtheria with complete success. I believe that 
the systematic use of definite, although often topical doses of whiskey, even in children 
of tender age, to be the surest safeguard against heart failure. 



PEROXIDE OF HYDROGEN IN TYPHOID FEVER. 

By F. H. WIGGIN, M. D., 55 w. 36TH st., New York. 
(Published by the New York Medical Record, November 28, 1891.) 

Having had good results in using Peroxide of Hydrogen locally in diphtheria and 
tonsilitis, and in infected wounds, it occurred to me, when a case of typhoid fever came 
under my care, during my summer practice, that this remedy might be beneficial, it 
being the most powerful non-poisonous germicide we possess. 

On August 24th I was called to see Abby M — , who gave a history of having been 
ill for a week with fever and diarrhoea. On examination I found a characteristic case of 
typhoid fever with temperature 104-^° F.; pulse, 130; rose spots, abdominal pain, tym- 
panites, diarrhoea, and mild delirium. I prescribed one ounce of 15-volume Peroxide 
of Hydrogen* to eight ounces of water, to be taken every three hours, by the mouth. 
On the following day I found the patient more comfortabk ; temperature 103° F.; pulse 
112; had had only two movements during the twenty-four hours; less delirium and less 
pain in head. On the 26th had had one movement; temperature 102° F., pulse 104; 
less tenderness in abdomen, and pain in the head diminishing. On the 27th, tempera- 
ture ioo£° F.; pulse 98; no movement; tympanites disappeared, and head, though still 
weak, clearer. On the 29th, temperature 99^°.; no movement. On the 30th, tem- 
perature normal; pulse, 84: formed movement. The case went on now uninterruptedly 
to recovery, with nothing further of interest to report. On the 9th of September I dis- 
continued my visits, the patient being discharged, cured, though weak. 

One swallow does not make a summer, but I report this case hoping that some one 
who has larger experience for treating typhoid fever may take up the suggestion and 
let the result be known. The remedy is perfectly harmless, easy to take, and appar- 
ently was of great value in this case. 

*Since the above report has been published by the New York Medical Record, Dr. F. H. Wiggin 
stated April 14, 1892, that Marchand's Peroxide of Hydrogen (medicinal) was used by him in this 
■ease. 



93 
SUBSTITUTION AND ITS ATTENDANT EVILS. 

By JOHN AULDE, M. D., 4719 Fraxkford Ave., Philadelphia, Pa. 

(Published by the Journal of 'the American Medical Association, Chicago, 111., Decem- 
ber 5th, 1891.) 

The evils attendant upon substitution and sophistication of remedial agents have 
long been surmised; they have not, however, until recently, received attention at the 
hands of the medical profession. Increased diagnostic skill, along with greatly im- 
proved facilities for the manufacture of medicaments, favor an approach toward mathe- 
matical exactness in computing therapeutic results. When these are wanting we 
challenge the character of the remedy. The question which presents itself is: Has our 
patient received the true medicament or a base counterfeit? However attractive in 
theory, it will be found impractical for the medical profession to drift away from the 
pharmacists and it should be our aim to reward the faithful and bring the guilty to pun- 
ishment. The friendly bond between the two professions should be honesty, as neither 
can afford to work independently; there is an interdependence which makes them mutu- 
ally helpful.- 

It is said of Lawson Tait, that he has returned to first principles and carries a mill 
with him, so that when ergot is needed, he prepares it fresh with his own hand. The 
reliable character of Squibb's ether has been maintained through his business sagacity in 
having it prepared chemically pure and distributed all over the world in sealed cans, 
thus precluding the possibility of sophistication or substitution. 

The life oi a patient suffering from rheumatism may depend upon his being supplied 
with sodium salicylate prepared by a combination of Merck's chemically pure bicarbonate 
of soda and true salicylic acid obtained from oil of wintergreen, and yet few pharmacists, 
even in large cities, pretend to keep either in stock. They are the exception in Phila- 
delphia, and doubtless the same is true of other cities. 

Some years ago Dr. Squibb, of Brooklyn, set his seal on Marchand's Peroxide of 
Hydrogen, by endorsing its character and defending its merits as the most powerful and 
yet harmless bactericide which could be employed in the treatment of various formidable 
and fatal diseases. Dr. Robert T. Morris, Dr. Paul Gibier, and other well-known 
authorities have corroborated his statements from clinical observation, and as a conse- 
quence, a revolution has taken place in our methods of treatment in both medical and 
surgical practice. The efficacy of this simple remedy, its innocuousness and extended 
field of application, have shed a flood of light upon modern, therapeutics, but at the 
same time there has followed in its train a host of worthless imitations. 

The substitution of the commercial for the medicinal peroxide is calculated to work 
serious injury and destroy our confidence in a most potent remedy. In the treatment of 
diphtheria, for instance, the commercial product is positively harmful. When death re- 
sults shall we blame the attending physician or the unscrupulous druggist who substi- 
tutes a base imitation for the genuine product? And still, pharmacists who claim to be 
respectable, do not hesitate to trifle thus with human life. Is it any wonder then, that 
our mortality percentages are on the wrong side? 

Cascara sagrada has been counterfeited and sophisticated until it is almost impossi- 
ble to secure a reliable preparation of this most useful medicament, although Parke, 
Davis & Co. , the pioneers in its introduction, have adopted every means in their power for 
the protection of fhe medical profession. Antipyrin, a patented preparation, has met 
with phenomenal sales, and possesses distinct therapeutic properties, and as a result, 
imitations and substitutes are offered to take its place in medical practice. Whether these 
imitations are better or worse than the original product, I do not care to discuss; neither 
is it for the druggist to decide. The decision here, as to any special remedy or prepara- 
tion, rests entirely with the physician, as he alone is responsible for the condition of his 
patient; no one else, not even the druggist, should be permitted to interfere with his 



94 

•directions. Substitution is an evil which should be guarded against; it is an evil which 
must be eradicated, or the entire medical structure will collapse. It is a duty we owe to 
ourselves and to our patients to look after this unnatural condition of affairs in which we 
are so vitally interested, and the time is near at hand when a systematic effort must be 
made with a view to accomplish the desired end. 

This subject is commended to the attention of the American Medical Association, 
with the suggestion that a committee be appointed who shall recommend suitable meas- 
ures for the protection of the medical profession from the evils of substitution and so- 
phistication on the part of unscrupulous druggists. Shall we have a list? 



HYDROGEN PEROXIDE IN PELVIC ABSCESS. 

(Published by the Bacteriological World of Battle Creek, Mich., December, 1891.) 

We have for a number of years made the use Peroxide of Hydrogen (Marchand's) 
in the treatment of suppurating surfaces, abscesses, etc., with excellent results, but have 
never observed a more gratifying result than that recently obtained in a case of pelvic 
abscess of long standing. The abscess discharged by a small opening just behind the 
cervix uteri, and was very profuse, and extraordinarily foetid. Our stock of Peroxide of 
Hydrogen happened to be exhausted at the time, the new supply ordered being somewhat 
delayed in reaching us, and we at first employed listerine, using it in. the proportion of 
one part to three of distilled water. There was no apparent effect upon the discharge, as 
regards either quantity or character. The odor continued as bad as ever. When the new 
supply of Peroxide of Hydrogen arrived, we immediately began using it in the proportion 
of one part to ten of distilled water, with the result that after the first washing the in- 
tensely foetid odor disappeared entirely, the discharge became healthy in appearance, and 
diminished in quantity so rapidly that within ten days there was no discharge whatever, 
except at the washing, and then the quantity evacuated was not more than a dram, when 
it had previously been several ounces, besides continuous discharge in the intervals be- 
tween the washings. 

After the first washing with Peroxide of Hydrogen, the patient's temperature, which 
Tiad for several months previously been above normal, fell to normal and has remained 
at that point since. There is certainly at present no agent known which could properly 
replace hydrogen peroxide as a disinfectant of unhealthy surfaces. 

It would seem to be especially valuable in the treatment of abscesses, the discharges 
of which, through the relation of the cavity and the lower part of the alimentary canal, 
usuallv possess so repulsive an odor as to render the existence of the patient almost un- 
endurable. J. H. K. 



DENTAL MEDICINE. 

By R. M. CHASE, D. D. S., M. D., Bethel, Vt. 

Abstract of paper read before the New England Dental Society, October 29, 1891. 

(Published by the International Dental Journal^ Philadelphia, January, 1892,) 

Peroxide of Hydrogen still stands at the head as a germicide, and undoubtedly is one 
of the best antiseptics yet discovered to annihilate germs, bacteria, or microbes, Charles 
Marchand's preparation, H 2 Oo, is, I believe, the best article in the market, as Peroxide 
of Hydrogen is very susceptible to certain conditions. • To get the best results it should 



95 

be kept in a cool place, well stoppered and when required for use as much as desired 
should be poured from a large bottle into a small receptacle, and only what it to be used 
should be exposed to the light. When small cavities are to be cleansed it should be in- 
jected with a small glass or rubber syringe, as metal should not be brought into contact 
with it as it quickly destroys its utility. For reaching pulp canals I find a small glass 
medicine dropper very convenient as by pressing upon the rubber bulb quickly it is 
forcibly ejected and thus forced into the pulp canal without much trouble. I use a wooden 
tooth pick reduced in size to still further push it into the root. In treating all ill-con- 
ditions of the oral cavity I make it a rule to first rinse thoroughly the mouth with peroxide 
diluted, and then apply remedies suitable for the same. Much more could be said and 
undoubtedly will be brought out in this discussion upon this and other valuable antiseptics. 



PEROXIDE OF HYDROGEN IN THE TREATMENT OF 

DIPHTHERIA. 

(Published by the North Western Medical Journal, Minneapolis, Minn., February, 1892) 

In the next chapter, we shall give further details with regard to the treatment of 
diphtheria, but at this point we feel that we should not close without announcing in the 
most emphatic terms, that one of the most available agents that we have for the fighting 
of diphtheria locally, and preventing constitutional involvement is the "Necessary Peroxide 
of Hydrogen" made by Chas. Marchand, of New York. We would take no chances by 
using any other manufacture. Charles Marchand was the pioneer in the development of 
this particular agent, for medical use. It is the "Medicinal Peroxide of Hydrogen which 
can be depended upon to render diphtheria germs inert as thoroughly as water can bede- 
pended upon to put out a fire, or as heat can be relied upon to annihilate the icicle. We 
believe that every case of sore throat, whether pronounced diphtheria or not, as well as 
every case of scarlet fever, should have applied to the throat at intervals varying accord- 
ing to the necessities of the situation, the full strength of the Marchand's Peroxide of 
Hydrogen. It may be used as a gargle, though I am somewhat in favor of flushing the 
parts with a good syringe, or if this is not available, owing to the objection of the patient, 
particularly if it be a little one, atomizers are now furnished which act very efficiently, 
and by using them frequently, the full effects can be secured. It is well to give internally 
occasionally, teaspoonful doses of the peroxide. It maybe diluted or not, as one pleases, 
All the secretion which has been swallowed will thus be acted upon in the stomach. In ad- 
dition, there is a general accumulation of fermentative products in the stomach, undi- 
gested food, etc. The oxidization of these irritants is desirable. If the patient complains 
that the application is irritating it may be diluted with one, two or three parts of water. 

The position which we took nearly four years ago with reference to the use of Perox- 
ide of Hydrogen in the treatment of diphtheria in a paper read before the St. Louis Medi- 
cal Scciety, has been strengthened with the experience which has followed. We would 
emphasize every material point then made in that paper. If asked "if we were to depend 
upon only one agent in the local treatment of diphtheria, what would we call for," the re- 
sponse would be emphatic, in thundering tones, ' ' Marchand's Peroxide of Hydrogen, " and 
if we ascertain that any druggist furnished our patient with any other than Marchand's 
it would be sufficient for us to condemn that druggist and rather than run the gauntlet 
of his repeating the offense, we would supply the medicament at our own expense. 



9 6 

RECENT INVESTIGATIONS RELATING TO THE 
PREVENTION OF DIPHTHERIA AND SCARLET FEVER. 

By Dr. J. LEWIS SMITH. 

Professor Diseases of Children, Bellevue Medical College, New York. 

Abstract of paper read before New York County Medical Association, March 21, 1892, 

(Published by the Doctor s Weekly, March 26, 1892.) 

In his report the author entered fully into the pathology and etiology of the two- 
diseases, and dwelt at some length on their differential diagnosis. He related many 
interesting facts in connection with the contagiousness of diphtheria, spoke of a case of 
the disease resultiong from the employment of a brush that had been used for swabbing 
the throat four years before in a similar trouble. Does not believe diphtheria ever origi- 
nates de novo, that it is dependent at all times on the presence of a specific microbe. 
Damp cellars, the presence of sewer gas and other unsanitary conditions contribute 
largely to its development. Many mild attacks of the disease are overlooked by the 
attending physician, and as a consequence it is communicated to others, notably in the 
school room. He believes in thorough disinfection as a means of preventing a spread of 
the disease. Does not have much faith in sulphur for this purpose; prefers a strong 
solution of corrosive sublimate or five per cent, solution of carbolic acid. This should 
be v.sed freely on walls and floors of rooms where the disease prevails. With the same 
solution the bedstead and other articles of furniture should be thoroughly washed. 

In examining patients suspected of having diphtheria or scarlet fever, the physician 
should place himself on one side or in the rear and not in front, as is usually the prac- 
tice. In this manner he avoids the dangers of any diseased matter that might be coughed 
up by the patient. After such examinations the physician should thoroughly bathe his 
hands and face in a solution of corrosive sublimate. Exclude everybody but the physi- 
cian and nurse from the room where a case of either disease exists. While small-pox is 
thoroughly under control in this city, he doesn't think it possible to gain such control 
over the two diseases under discussion. The crowded condition of our large tenement 
houses supplies so much material for their ravages that it is impossible to stamp them 
out. For the purpose of illustration, the reader related the following experience: 

He was called to seethe child of a poor woman, living in a tenement house in which 
there were twenty-seven families. He found a child two years old very sick with diph- 
theria. Five other children lived in the same rooms; of these, two were away at time 
of his visit, at school. Just think of the hundreds of children thus exposed! The sick 
child died two days later. 

For purpose of fumigation the author recommended the following: 
1^ 01. eucalyptus, 

Acid carbolic, aa § j. 
Spir. turpentine, § viij. 

M. Add two tablespoonfuls of this mixture to a pint of water and evaporate by aid 
of a lamp; or cloths saturated with the mixture may be hung around the room. 

Does not believe in the efficacy of sulphur fumigation. Microbes in a state of activity 
may be found in the sweepings obtained from a room that has been fumigated with sulphur. 

For the local treatment of diphtheria and scarlet fever, he recommends the following: 
I£ 01. eucalyptus, 

Acid carbolic, aa 3 j. 
01. olive, § vij. 

M. Sig. Apply every three hours. 

He also uses Marchand's medicinal Peroxide of Hydrogen one part, to three parts 



97 

of water, with much satisfaction. It is prompt in action and quickly destroys the diph- 
theric membrane. 

Dr. Smith's paper was discussed by Drs. Leale, Tyndale and Koplik. 



SOME NOTES ON THE VALUE OF PEROXIDE OF 

HYDROGEN. 

By ROBERT T. WILSON, M. D., Baltimore, Md. 

Assistant Surgeon to the Hospital for the Women of Maryland, 

Editor of Practice^ Richmond, Va. : 

Having read in the January number of your excellent journal, the experience of Dr. 
S. Potts Eagleton in the use of "Hydrogen Peroxide in Surgical Affections," I am 
prompted to send you for publication the following-. 

In January I was called to see a lady in her seventy-six year of age, suffering, as her 
husband supposed, from an inguinal hernia, but upon careful examination, I diagnosed 
a deep-seated abscess, and at once ordered hot poultices, to be made of equal parts of 
flax-seed and corn meal, and applied in the following manner over the skin: White gauze, 
hot poultice, muslin, oil silk. After a few poultices had been used it was in a condition 
to be opened. A good incision, giving free drainage was made. The cavity was eight 
inches in depth. Every day the cavity is syringed with "Peroxide of Hydrogen" (Mar- 
chand's) full strength. 

The first effect noticed was the rapid oxidation of all purulent matter, which caused 
the distention of the cavity with the gas eliminated as a frothy yellowish (or yellowish* 
green) bubbling substance. After the oxidation is completed the wound is always in a 
clean, sweet condition, absolutely free from pus. The cavity is dusted with iodoform, 
and antiseptic dressings applied. The cavity is gradually healing up from the bottom. 
In my experience "Peroxide of Hydrogen" (Marchand's) perceptibly diminishes the pus 
formation. In this connection, I will also state that I am using "Peroxide of Hyrdogen" 
in a case upon which I operated February 16, and from which was removed a large 
multilocular ovarian tumor and also an enlarged uterus with many fibroids (hysterec- 
tomy). The wound (stump) is in a healthy condition; her general condition is good. 
Indeed, she is getting along finely. The clamp came away yesterday. The sixteenth 
day was up yesterday, counting by hours, from the time of the operation. The wound 
is in a healthy state, and perfectly healed. Hardly a day passes that I am not using the 
"Peroxide of Hydrogen" in my practice. I send you these notes, hoping they will 
assist some brother practitioner who may be a reader of your practical journal. Doctors 
talk with each other about their cases, and I believe they are as much interested in 
exchanging their experiences by correspondence. We are all mutually concerned. 



DIPHTHERIA, LOCAL TREATMENT. \ 

By I. X. LOVE, M. D., St. Louis, Mo. 

(Published by the Medical Mirror, of St. Louis, March, 1892.) 

Judgment should be exercised in this as in everything else. If we select the applica- 
tions properly they will be sufficiently agreeable as not to annoy or irritate more than 
they benefit It may be necessary to avail an opportunity for the application; for the 
patient may be fretful, easily demoralized by being disturbed; we should wait until rest 
has been secured, until the sensibilities have been obtunded by proper internal medication. 



We should bring to bear our ingenuity to the fullest and diplomacy also; if possible ascer- 
tain if the child has a fondness for any particular thing. We should arrange a plan by 
which a reward in prospect may assist in accomplishing our desires. 

For its germicidal effect, and also for the removal of the mechanical obstruction 
produced by the diphtheritic membrane, Marchand's Peroxide of Hydrogen, (medicinal) 
should be used promptly, in its full strength, but later it may be diluted to one-half 
strength. As the mucous membrane becomes exposed after the removal of the deposit, 
by the means just mentioned, it is important to have on hand an application which is 
soothing, astringent and at the same time as much antiseptic as it can be made. 

I have found the following valuable for this purpose. 
1$ Katharmon., § ij. 
Glycerine, \ j. 
Aquse Cinnamonis, § iij. Sig. 

The Peroxide of Hydrogen may be labelled No. I, the formula just written No. 2. 
The best means of applying both applications is either by a glass syringe or an atomizer 
made of hard rubber; but in case neither of these appliances are at hand or available, a 
piece of wire (silver or platinum) of good strength, may be bent, with a hook at the end, 
in such a manner, as to serve as a probang by wrapping a pledget of absorbent cotton at 
the point; the application may be made after thoroughly wetting the same with the 
solution. No. 2 application should follow No. 1, and will be gratefully received by the 
little patient. 



WOUND CLOSURE AFTER THE EMPYEMA OPERATION. 
By CHARLES W. AITKIN, M. D., Flemingsburg, Ky. 
(Published by the Ohio Medical Journal, of Cincinnati, April, 1892.) 

Several times the writer has found it difficult to close the wound made in an operation 
for empyema, especially if the empyema was of any magnitude or of long standing, so 
that the lung's function was destroyed by compression, and bound down by adhesions. 

Mrs. V. , set. 32, of Bath County, Ky., was confined April 20, 1891. The physician in 
attendance, Dr. Judy, informs me that there was nothing abnormal in the labor. On 
April 30th the patient had a chill, and for several days the temperature ranged from 103 
to 104. 5 . After a few days more she began to complain of pain in left chest and 
shoulder. I saw her on May 24, in consultation with Drs. Judy and Sharpe, and we agreed 
to aspirate the left chest; over four pints of fluid were removed; two and one-half pints 
were fair serum, but the last one and one-half pints had some purulent appearance. 
During the next six weeks the patient was aspirated several times, and over ten pints of 
sero purulent fluid was removed at these various tappings. At this time a thoracotomy 
was decided upon. The patient was taken to the Good Samaritan Hospital, and with the 
aid of Dr. French, with the house physicians, Drs. B'^.el and Schoolfield, I opened the 
chest and let out over four pints of pus, the cavity was thoroughly washed with a saturated 
boracic solution, and the usual drainage and dressing applied, the case was left in Dr. 
French's care. The flow of pus was considerable for a week, after that time the boracic 
irrigation was followed by washing the cavity every day with Peroxide of Hydrogen. 
The quantity of pus rapidly diminished, the patient gained in strength and weight, and 
in about four weeks more came back to her Kentucky home. Her husband continued 
washing the cavity with both the boric solution and H 2 2 until September 12, when I 
again looked after the case for a week, preparatory to closing the wound, but as there 
was still an ounce or so of pus passing per diem, it was thought advisable to continue 
the Peroxide a while longer. This was kept up a month, when the quantity discharged 
was not more than one-half ounce a day, but to shut off this drainage for twenty-four 
hours would cause an elevated temperature and general septic symptoms; at this time a 



99 

i to 4000 bichloride solution was substituted for the boracic solution, the H 2 2 being 
continued, a slight bloody discharge was thrown out for a few days, but lessened 
gradually, until November 3, when I washed the cavity with a 1 to 5000 bichloride 
solution, followed with the Peroxide of Hydrogen for a few days, and let the wound 
heal without any unpleasant symptoms. The chest was measured during February, 
1892, and at auxiliary, mammary and ensiform levels, the left semi-circumference was 
one inch less than the right. The Peroxide of Hydrogen certainly aided very materially 
in arresting the suppurative process. Marchand's pure Peroxide of Hydrogen was used 
with but little dilution. 



AX INTERESTING CASE OF EMPYEMA WITH SPECIAL 

REFERENCE TO THE USE OF PEROXIDE OF 

HYDROGEN. 

By H. F. BROWNLEE. M. D., Danbury, Conn. 

(Published by New England Medical Monthly, June, 1892.) 

This case is interesting in many ways; namely, the length of time which elapsed 
previous to diagnosis, the degree of exhaustion present at that time, the amount of pus 
evacuated, and finally, the perfect and rapid recovery of the patient. 

Previous to his sickness, this patient was a strong healthy man of about 30 years of 
age, but who for a few years past had indulged in rather frequent dissipation. 

About December 20th he was suddenly taken very sick. The attending physician 
diagnosed pneumonia and began a vigorous course of treatment which he continued for 
four weeks. The pneumonia did not resolve but the attending physician continued 
diligently in his efforts to bring about resolution and at the time I saw him first, over 
four weeks after the beginning of the attack he was supplied with four glasses of medi- 
cine with instructions to take a teaspoonful of each every hour. Upon examination I 
diagnosed empyema and demonstrated it by the introduction of a hypodermic needle. 

At this time the patient was in a condition of extreme exhaustion; temp. 105, pulse 
"hardly perceptible, respiration 48. I had him removed at once to the Danbury hospital; 
a small amount of ether was administered and a resection performed, removing about an 
inch of the sixth rib in the axillary line. An opening was then made into the pleural 
cavity and two gallons of pus evacuated. I did not know the maximum amount of pus 
ever evacuated in a case of this kind, but I can hardly conceive of a greater amount 
being contained in the pleural cavity of an ordinary man. The cavity was washed out 
with Thiersch's Sol., and two large drainage tubes placed in the wound. The patient 
became quite cyanotic during the operation and required very active stimulation for 
several hours afterward. 

So much for the case itself, now a few words in regard to his treatment and course 
of recovery. For two weeks the pleural cavity was washed out every day with Thiersch's 
Sol. The patient slowly improved but his temperature continued to rise every evening 
to 102 or 103. I then substituted a Sol. Hydrarg. Bichloride 1-5000, This was used 
about a week when a very active salivation presented itself. During this time the tem- 
perature did not run so high but still continued at about 101 to 101-^- in the evening. I 
then began washing out the cavity with Peroxide of Hydrogen and if I had done this 
before I would certainly have gained considerable time. I used Marchand's prepara- 
tion, full strength, putting in a considerable quantity of it with a small syringe, then 
allowing it to escape and finally washing it all out with a weak Borated Solution. 

From this time my patient began rapidly to improve. The temperature fell to 
almost nothing, rarely exceeding 99^ at night. In two weeks from this time the dis- 



charge had entirely stopped and I was enabled to remove my drainage tubes, the wound 
closing in a few days. He gained rapidly in strength and in eight weeks from the day 
of operation he was able to return to work. 

I cannot say too much in praise of Marchand's Peroxide of Hydrogen (Medicinal) 
in the treatment of this case. It kept the pleural cavity so clean that there was hardly 
any septic absorption and finally prevented all formation of pus, the discharge ceasing 
entirely in two weeks from the time I began its use. 



THE VALUE OF PEROXIDE OF HYDROGEN IN THE 

TREATMENT OF CHRONIC GONORRHOEA, 

ILLUSTRATED BY A CASE. 

By WILLIAMS ROBERTS, Plattsburgh Barracks, N. Y. 

Hospital Steward, U. S. Army. 

(Published by Journal of the American Medical Association, Chicago, 111., April 30,. 

1892.) 

During the past few years, the many articles on new drugs in the treatment of gon- 
orrhoea leave nothing to be desired in this way. The present article contains nothing 
new, but simply gives the history of a case of chronic gonorrhoea arrested by the use of 
Peroxide of Hydrogen — a drug that is "going the rounds," probably to be discarded by 
reason of its being so unhandy and so little understood. 

The following case might serve to illustrate the value of Peroxide of Hydrogen,. 
when used under conditions favorable to the preservation of the drug. 

J. H., citizen, age 23, contracted a gonorrhoea March 20, 1890, and received the 
usual orthodox treatment by internal medication up to July 7th, 1890, the date at which 
the patient came under my observation. I found a subacute gonorrhoea, which was 
somewhat relieved by urethral injections, including the iodoform et tannic injection of 
Dr. Otis. 

On August 15th, 1890, the patient complained of difficult micturition, and upon 
examining the urethral canal, I found the following condition: 

Size of urethra at bulb, No. 32 French; 4 inches from meatus, a No. 21 stricture, 
meatus contracted to No. 20. 

The constriction at the meatus was relieved by incision, and the stricture readily 
yielded to gradual dilatation, and on August 31,1890, a No. 31 sound was passed without 
pain. On September I, 1890, an examination of the urethral canal showed the presence 
of a small ulcer at the side of the old stricture, and stimulating injections were ordered 
— without, however, relieving the "morning drop." This drop I examined microscop- 
ically, and found pus and mucus corpuscles, with small gonorrhceal threads. 

On December 10, 1890, I again examined the urethra, and found the conditions 
about the same. I had tried the whole list of anti-gonorrhceal remedies, including 
the medicated urethral bougies and the passage of steel sounds, and was somewhat 
puzzled to relieve the obstinate form which the disease had assumed. 

On January 26, 1891, I commenced the use of Marchand's Peroxide of Hydrogen, 

15 volumes, and "Glycozone," with the following results: Two drachms of a mixture of: 

1$ Peroxide of Hydrogen, § ss. 

Aqua?, 1 iss. M. 

was used to distend the urethra, and held for thirty seconds, and then allowed to escape,. 

The decomposition of the H 2 O3 was verv active, showing the presence of pus. I then 



injected I drachm, which was allowed to remain in the canal two minutes. I repeated 
this procedure t, i. d., and at bedtime injected one drachm of "Glycozone." This 
treatment was pursued up to February 9, iSgi, when there was no discharge, and the 
patient declared himself cured. 

I had watched this case with great interest, for it was the most obstinate one I had 
«ver seen in not yielding to some one of the many lauded cures for chronic gonorrhoea. 
During seven months the patient had been under constant treatment, to find that a three 
weeks' course of treatment by Peroxide of Hydrogen terminated the case quite satis- 
factorily. 

The above data might naturally turn the reader's thoughts to the nature of the 
remedial agent that succeeded where all others had failed. 

The Peroxide of Hydrogen was that prepared by Chas. Marchand of New York. 
The chemistry of this compound together with the pathological conditions it may be 
applied to, I will leave to the many advertising agents, and will simply state the care 
with which the preparation should be preserved, for there are factors which utterly 
destroy the medicinal properties of this valuable agent. 



PEROXIDE OF HYDROGEN AS A DEODORIZER IN CANCER 

OF THE UTERUS. 

By GEORGE W. KAAN, M. D. 

Surgeon to Out-Patients, Free Hospital for Women, Boston. 

(Published by the Boston Medical aud Surgical Journal, April 7, 1892.) 

The value of Peroxide of Hydrogen in washing out sinuses and abscess cavities, has 
led me to use it recently as a vaginal injection in cancer of the uterus; and with gratifying 
results. 

My cases have been few; but in each the distinctive cancerous odor was noticeable 
about the patient before the use of the Peroxide of Hydrogen and absent afterwards. In 
one out-patient case the fetor was so pronounced, that the air of the room seemed 
saturated with it, the moment she entered. When I last saw her in making an examination 
no odor was perceptible a foot from the vulva, and only slightly so, close to it. In this case 
she had used the injection the night before, and a cancerous mass as large as a man's 
fist, hangs in the vagina, within two inches of the vulva. This case has had palliative 
treatment in the hospital, by curreting, Paquelin's cautery, and chloride of zinc applica- 
tions. When she first came to me the disease had extended over the whole anterior 
vaginal wall; since then the Peroxide of Hydrogen has been used, and the anterior wall is 
clear. It seems to me that the injections have had some curative action. 

Further observation, of course, is necessary, but bearing in mind what Sir Spencer 
Wells says of cancer and cancerous diseases, that everything in relation to it is so impor- 
tant that nothing should be thought a trifle, and my material being limited, I venture to 
state the facts as they appear to me in this case. 

Regardless, however, of any value it may have as a curative agent, its use as a deo- 
dorizer, and this without substituting another odor for the cancerous one, makes it of 
inestimable worth in adding to the comfort of the patients, where palliative treatment 
alone is all that remains. 

The method of using has been to take about an ounce of the Peroxide of Hydrogen 
and an equal quantity of water, warmed by being placed in a pan of hot water, and 
injected through a soft rubber catheter, so that the injection shall be sure to reach the 
back part of the vagina. Such an injection once or twice a day has been sufficient. 



PEROXIDE OF HYDROGEN AS A LOCAL APPLICATION IN 
RHUS TOX POISONING. 

By N. H. HAIGHT, M. D., Oakland, Cal. 
(Published by The Homcepathic News, of St. Louis, Mo., July, 1892,) 

May 20, 1892, I was called to treat a young lady who was suffering from the 
effects of poison oak. She had been suffering for nearly a week, and had tried every- 
thing that friends had recommended, but continued to grow worse. The left side of 
her face was so badly swollen that the eye of that side was entirely closed and she 
was suffering intense itching and pain. 

I have never heard of Peroxide of Hydrogen being employed in such cases before, 
but not feeling satisfied with the treatment that I had used in the past, I decided to ex- 
periment on this case. I used Marchand's Peroxide of Hydrogen (medicinal), feeling 
sure it would reduce the inflammation, and by so doing, it would naturally allay 
the itching. I used in the following proportions: Peroxide of Hydrogen, 1 part; dis- 
tilled water 2 parts; applied to the affected parts every hour. I also gave internal treat- 
ment of croton tig. 200. The next morning I called to see how the case was progress- 
ing, and found her very comfortable, the itching and swelling being very much less. I 
continued the same treatment, and on the fourth day the case was cured. On another 
case I used H 2 2 1 part, tincture grendilla robusta 2 parts, with equally good results 
but no better. 



MEDICINAL VS. COMMERCIAL PEROXIDE OF HYDROGEN. 
By W. B. DEWEES, M. 1)., Salina, Kas. 

To the Editor of the Medical Herald, St. Joseph, Mo.: 

Professional indifference and professional inactivity are probably the two greatest 
enemies to our individual progress in the profession. Whereas cultivation will alone fit 
us individually with that broad-gauge knowledge, the practical appreciation of which 
marks, with lasting effect, the progress to success. Hence, earnest interest and labor 
are essential requisites, if we would learn to discriminate between the opportunities pre- 
senting, lest we cultivate a flowerless plant or we find weeds instead of roses when we 
look for success. This is aptly illustrated by the course pursued with regard to the 
selection of remedial agents by so many of us in the profession, from time to time, and 
probably in no instance more forcibly than in the use of Peroxide of Hydrogen, 
(H 2 2 .) In this connection, I feel it but a personal duty to the profession to record 
my own experience with this agent, having for several years made use of Peroxide of 
Hydrogen in suitable cases (/. e., chiefly where pus formation was found), with very 
varying results. Like most of my brethren, I took it for granted that H 2 0,g was the 
same, so long as it was made by our leading manufacturing chemists, and consequentlv 
paid no attention as to the effects of special brands, since I felt confident that my drug- 
gist was handling only the products of first-class manufacturers, and could distinguish 
between the "Commercial" and "Medicinal" articles. The result being that I was not 
impressed with anything like an absolute confidence in this agent to arrest pus forma- 
tion. It was not till in October, 1891, when in attendance at the annual meeting of the 
Mississippi Valley Medical Association in St. Louis, that in a personal interview with 
Dr. Charles Marchand, of New York, relative to the product of his manufacture, that I 
decided to give this agent another fair trial, and watching the effects carefully with 
reference to the different makes in the market. This upon the avowed assurance of Dr. 
Marchand, there was a most striking difference in the result of using the product of 
different manufacturers. After almost another year of numerous trials and careful 



103 

accurate observation with a number of different makes in the market, I am prepared to 
confidently endorse all that is claimed for the superiority of Marchand's make. I have 
used three different products alike in abscesses of almost every description, ulcers, gan- 
grene, cancer, endometritis, specific vaginitis, diphtheria, etc., etc., and in each and 
every instance Marchand's preparation proved above all, not only the most effectual, 
but in every way a most satisfactory agent for arresting pus formation, and as a non- 
irritating antiseptic for general use. Therefore, I most earnestly counsel my fellow 
co-laborers in the profession to be particular in specifying Marchand's Peroxide of Hy- 
drogen (medicinal) whenever this agent is called in use by them. 



RETAINED NASAL SECRETION OR SYPHILITIC 
RHINITIS ? * 

By C. E. PERKINS, M. D., Sandusky, O. 

(Published by the Medical Standard, of Chicago, 111., Oct., 1892.) 

Few cases of acute catarrhal rhinitis are sufficiently severe to compel a patient to 
consult a physician. When such cases occur the symptoms are severe and the diagnosis 
difficult. 

February 7, a 30-year-old unmarried woman, with negative family history as to 
tuberculosis, rheumatism or lues, consulted me. There was no evidence of lues. The 
patient had an attack of measels in 1 891, from which she and five other members of the 
family recovered without results of any kind. Up to the commencement of this trouble 
she had been exceptionally healthy and robust, having never required the services of a 
physician. 

In the latter part of October last she was taken with what she considered an ordi- 
nary cold. There was the ordinary symptoms of acute catarrhal rhinitis, viz.: malaise, 
dryness and heat of the nose followed by discharge, etc., but she had in addition to all 
these a severe neuralgia on the right side of the face, which persisted for about a month. 
Early in December complete stenosis of the right side of the nose developed and the left 
was partially occluded. At this time there was a swelling across the nose, frontal and 
nasal pains, and slight epiphora, and there was very little running from the nose and 
that of a watery character. About these same symptoms continued until just before 
Christmas when she consulted her physician. I am quite certain that he considered the 
case as one of nasal syphilis, for he prescribed mercurial inunctions and insufflated iodo- 
form daily. She continued under his care for six weeks. At one time in January she 
had a hoarseness for one week. The right nostril continued occluded, and the left be- 
came completely so, although he was adopting rigorous anti-syphilitic treatment. Not 
making any improvement she consulted me on February 9. I found her weak and 
anaemic and somewhat emaciated. There was complete loss of apetite, and swelling, 
redness and pains across the nose. 

These pains were so severe as to interfere with sleep; there was complete stenosis 
of both nasal passages which caused the characteristic voice of nasal occlusion. This, 
upon inspection, appeared to be due to thickening and infiltration of the tubinated 
bodies and septum; they were in contact about one-fourth of an inch from the anterior 
nares. Having benumbed the parts with cocaine, I introduced a probe wound with cot- 
ton, beyond this point of contact and brought out some cheesy matter of disagreeable 
odor. I was unable to get a thorough view of the nasal cavities at that time, so I 
directed her to return on the following day; then I found the oedema somewhat subsided, 
and saw that there was a polypoid enlargement of the little turbinated bodies which 
acted as a valve to imprison the decomposing material. 

♦Ohio Med. Soc. Trans. Cond. 



104 

This I removed with a cold wire snare, and thus opened up a regular cavity on each 
side, from which I removed at least an ounce of foul-smelling, cheesy pus. I might add 
that this accumulation was above the middle turbinateds so far as I could make out. 
As the parts were thus opened, and the discharge was enabled to make an exit, it gave 
rise, by running down into the throat, to a very distressing nausea. This I succeeded 
in relieving by daily removing these secretions and spraying the nares with a solution of 
Peroxide of Hydrogen ("Marchand's") one to four of water, with a mixture taken intern- 
ally, of pepsins and bismuth. I also prescribed champagne. Under this treatment the 
patient soon began to improve. She regained her appetite, the stenosis was relieved, 
fcetor stopped, and she began to gain in flesh and strength, and on March 4 1 permitted 
her to go home, some ten miles, to report occasionally; she continued to improve until 
March 24 when she returned complaining of obstruction in the right nasal cavity. Then 
I removed the last bit of decomposed mucus, which had become very much hardened; 
since which time she has remained well. I examined her on April 26 and found the 
nasal cavities as nearly normal as we are accustomed to see them; there is no ulceration 
nor was there any more perforation of the septum, or anything to suggest that a syphi- 
litic process had been going on. 



TREATMENT OF DIPHTHERIA. 

By S. H. SHERMAN, M. D., Boston. 

Read before the Massachusetts Homeopathic Medical Society. 

(Published by the New England Medical Gazette, Boston, Mass., October, 1892.) 

Intelligent treatment of diphtheria as well as intelligent treatment of other diseases 
presupposes true conceptions of the nature of the disease. I take it for granted, with 
the incontrovertible evidence on the subject, that the cause of the disease, diphtheria, is 
the introduction into the system of microscopic germs, bacteria. Without these germs 
no diphtheria. The first point of attack is the natural one wherein the act of breathing 
they would come in contact with the tonsils and soft palate or mucous membrane of the 
nose. In mild attacks the disease remains a local one, the general system becoming lit- 
tle affected. In the severe cases it extends to almost every organ in the body. 

On the supposition that the disease is caused by germs, then to cure the disease, 
we must destroy or antagonize them. Have we any remedy that will do this? Yes, 
several; bichloride of mercury is the chief, but doses sufficient to overcome the germs 
would be dangerous to the patient. We have long been looking for a remedy that 
would be a potent germ-destroyer and still one harmless to the patient. I believe that 
remedy is now found. Some four years ago there was sent to me a pamphlet treating 
of Peroxide of Hydrogen, and the author especially dwelt upon the efficacy as an oxi- 
dizer of pus. About this time I had a patient in the Homoeopathic Hospital under 
treatment for cancer of the cervix uteri, and asked one of the staff of the able corps of 
surgeons what he thought of Peroxide of Hydrogen as an application to the broken 
down cervix. His reply was that he did not think much of it; and having such great 
confidence in my friend's judgment, I relegated it to the list of the numberless nostrums 
that we are invited to investigate. A few months ago my attention was again called to 
this remedy by a circular of testimonials from men eminent in the profession, and from 
all schools of practice. These men had proven it to be a safe and certain germicide. I 
sent for half pound bottle of this remedy and waited for a suitable case on which to test 
it. It soon came. On August 29, 1891, I was called to Mrs. B — , Athens Street, an 
unhealthy locality, with cesspool connecting with street sewer directly in front of the 
house, and the street a very narrow one. Found my patient in bed with history of three 
days' illness; fever, malaise, sore and swollen throat. On looking into the throat I 



i°5 

found tonsils, uvula, and soft palate covered with the characteristic diphtheritic deposit, 
and portions of it assumed that dark hue so characteristic of fatal cases, and almost 
certain to be followed by the septic form of the disease. There was much swelling of 
the sub-maxillary, sub-lingual, cervical and parotid glands. Deglutition was accom- 
plished with great difficulty, a considerable portion of any liquid swallowed returning 
through the nose. There was also prominent laryngeal symptoms, croupous cough, 
etc., showing that the disease had already invaded the larynx. From previous experi- 
ence in such cases my prognosis was unfavorable, for such cases are generally fatal even 
in good constitutions, under which head this patient could not be classed; her general 
health being rather below par. I began treatment by spraying the throat with Mar- 
chand's Peroxide of Hydrogen (medicinal) by means of a hand atomizer with hard 
rubber attachments, as metallic ones are oxidized by the remedy. The effect was im- 
mediately apparent on the diphtheritic deposit. I could see dissolution of the mem- 
brane about the thin edges, the fibrinous portion contracting into a smaller compass. 
The patient complained, however, of an extreme smarting sensation in the throat so that 
I felt obliged to dilute the peroxide with an equal quantity of water which did not seem 
to materially impair its efficacy. These inhalations or rather sprayings were repeated 
every two hours, and the time occupied at each seance from five to ten minutes. The 
dark necrotic condition had changed in twelve hours to the more common grayish-white 
deposit. From this time on there was a gradual diminishing of the exudation, although 
there was a persistent tendency to re-appearance of the membrane after it had been re- 
moved. The only internal remedies given were arsenicum, bichromate of potash, and 
glycozone. The arsenicum for the general condition of the system, the bichromate for 
the croupy or laryngeal complications, and the glycozone to destroy the bacteria, the 
ptomaines and leucomaines that may have found their way into the stomach, alimentary 
canal, the absorbent and circulatory systems. It was five days before the throat was 
free from diphtheritic deposit, and some eight days before the glandular swelling had 
subsided. There was but a remnant of the uvula left after the sloughing off of the 
membrane, and a loss of voice from the fourth to the fifteenth day. The patient was 
greatly prostrated from the first, and rallied rather slowly under the use of concentrated 
nutriment and mild stimulants. On the whole, considering the gravity of the case, the 
result was better than I have before witnessed in similar cases. 

Another case worthy of mention in this connection is the following: On March the 
31, 1892, was called up very early in the morning to see Master Terrance V. Freeman, 
aged three years and three months. The father told me the child had been ill for about 
a week with what he and his wife considered an ordinary cold, but soon after midnight 
of the present morning he was seized with a distressing croupy cough. On visiting the 
little patient I found the characteristic croup symptoms were apparent. I made an ex- 
amination of the throat and found both tonsils covered with diphtheritic membrane. My 
prescription was bichromate of potash first decimal trituration in half a glass or water, 
and carbonate of ammonia, one drachm in four ounces of cinnamon water. These 
remedies were given in alternation every one and one-half hours, and the throat was 
sprayed every two hours, night and day, with equal parts of Marchand's Peroxide of 
Hydrogen and water by means of a hand atomizer with hard rubber attachments. This 
line of treatment was persisted in with alternate remission and exacerbation of the symp- 
toms for five days, when the disease seemed under subjection, and convalescence secured, 
which continued uninterruptedly until the tenth day, when I discharged the case. This 
child was naturally a frail-looking child, though it showed a remarkable vitality through 
this severe and protracted disease. It was given from the first all the nutritious food it 
could be induced to take, consisting mostly of milk and bovinine. That it was diph- 
theritic croup was evidenced by the membrane detached and coughed up at different 
times during the disease. On one or two occasions the child nearly suffocated by the 
loose membrane being drawn into the larynx or trachea, and subsequently expelled. It 
is my opinion that this child would have died had it not been for the Peroxide of Hy- 
drogen. It may seem a difficult thing to spray a child's throat effectively for five min- 



io6 

utes at each seance, as the child will not voluntarily hold its mouth open. I overcome 
this difficulty by putting a fork-handle between the teeth on one side of the mouth, and 
having it held by an assistant standing behind the child and holding its head in position 
at the same time. 

I have used this remedy, Peroxide of Hydrogen, in several other cases of diphtheria 
of a mild form, which would not be of interest to report as they all made satisfactory 
recoveries, and probably would have under usual treatment. 

What is Peroxide of Hydrogen? "The name hydrogen dioxide expresses its com- 
position, and its formula H 2 2 represents this name. Hydrogen monoxide, H 2 0, or 
water, can under certain conditions, be made to combine with a second molecule or oxy- 
gen, the result being a water-like liquid, H 2 2 ." This agent is one and one-half times 
more potent as a germicide than corrosive sublimate and perfectly harmless. It is 
adapted to all zymotic diseases and suppurative processes. It will follow a pus sinus as 
a ferret will follow a rat, and be sure of destroying the pus and germs. 

I alluded to this remedy some months since at a meeting of the Boston Homoeopathic 
Medical Society, when the subject of Gonorrhoea was under discussion, and the editor 
of our much valued Gazette remarked that there was hardly anything in medical litera- 
ture concerning it, and that what was known about the remedy came chiefly from the 
manufacturer. This caused me to look up the subject, and I find an amount of pub- 
lished testimony altogether too voluminous to be quoted. 



MEDICAL DEPARTMENT SURGEON-GENERAL'S OFFICE. 

Headquarters of the First Brigade Michigan State Troops. 

Chas. Marchand, N. Y.: 

Dear Sir — I promised you I would write you further about the Peroxide of Hy- 
drogen (medicinal) manufactured by yourself. 

I have cured a great many cases of throat diseases with it, and one case of severe 
cystitis in an old man of 70, which I had treated with mild solutions of corrosive subli- 
mate for nearly two weeks; he was benefited a little. I then used one-half ounce of 
your Peroxide of Hydrogen to a pint of boiled and strained rain water, and washed out 
the bladder thoroughly with this, — the man got up next day and was up every day after 
that, was well in three days with only one injection or washing, it is worth its weight if 
used only in cases of cystitis. 

Yours truly, 

C. M. WOODWARD, Surg. General M. S. T. 
Tecumsch, Mich., Sept. 15, 1892. 



THE PEROXIDE OF HYDROGEN (MEDICINAL); AN INDIS- 
PENSABLE WOUND STERILIZER. 

By GEORGE H. PIERCE, M. D., Brooklyn, N. Y. 

(Published by New England Medical Monthly, November, 1892.) 

Probably the use most frequently made of this preparation, is in the cleansing of 
pus cavities, and suppurating surfaces. Any trace of pus remaining in any recess which 
an ordinary douche will not reach, is at once sought out by the peroxide, decomposed, 
and brought to the surface, in bubbles of gas. It is useful in cleansing off ulcers, 
sloughs and gangrenous tissues, chancres, diphtheritic patches, etc., and in cleansing, 
sinuses, and suppurating cavities, such as the pleural in empyaema, and the uterus where 



107 

there is putrid discharge, and in cleansing discharges where either puncture or free incis- 
ion has been made, it is invaluable, clearing out the pus as nothing else can do. There 
is one class of disease where its local action as a cleanser must be seen to be appreciated ; 
and that is as a disinfectant for gangrenous growths. In a case of extensive epitheliomia 
of the face, where only pilliative measures were of use, I found the Peroxide of Hydro- 
gen a very Godsend. This case was one of the most foul I had ever witnessed. When 
I first saw it, the odor from it was so great that it filled the house. It was covered with 
a cloth into which the discharge had accumulated, thus adding a greater bulk of fetid 
decomposition; and to add to the horror, for such it was, upon removing the cloth, the 
surface was swarming with maggots, as large and active, as may be found in a heap of 
decomposing garbage, and not only on the surface, but they extended deeply in sinuses 
below the ear where it was impossible to reach them, except as they would come to the 
surface. My first impulse was to invoke Beelzebub for some patent exterminator, but 
finding myself left to my own resources, I set about bringing destruction as best I could. 
As time was of some moment, I removed what I could reach with dressing forceps, then 
douched with bichloride, i-iooo, then with Peroxide of Hydrogen, 15 vol. strength, rinsed 
this off with warm water, and douched again thoroughly, with permanganate of potash 
solution, and finally dusted the whole with beechwood charcoal, which, in addition to act- 
ing as an absorbent to the gases, made an appearance very much to be preferred to the 
ordinary gangrenous appearance. I ordered the cloth to be left off entirely; first, be- 
cause it only added an additional fetid surface, and second, because the growth was very 
vascular and would bleed easily on being disturbed. It was dressed morning and night, 
and henceforth was kept almost entirely free from odor. 

The same routine was gone through with each day. First, Peroxide of Hydrogen, 
which was applied by pouring it directly from the bottle in which it came, on absorbent 
cotton held by dressing forceps, so that it dropped directly on the growth; when im- 
mediately a white foam would cover the surface, from the disintegration of pus, gangren- 
ous shreds, blood, etc. Second, rinsing off with warm water, then with permanganate 
of potash solr gr. ij., cupful of water, allowing it to drip from a wad of cotton over the 
surface. Third, dusting with charcoal and leaving it uncovered. An immense lot of 
Peroxide was consumed in this case, being purchased in i lb. bottles, six at a time. This 
seems to me a very effective means of keeping clean these foul discharging growths of 
the carcinomatous class; the Peroxide and permanganate, being the most thorough disin- 
fecting combination; and if employed in any case of cancerous growth, where palliation 
alone must be relied on, will make that life and the lives of those closely associated with 
it, more endurable. One important fact remains in regard to the chemical properties of 
the Peroxide. To be effectual it must be kept from the air, tightly corked, in a dark 
bottle, and in a cool place. It must be used directly from the original bottle. Do not 
permit the druggist to pour from one bottle to another when dispensing it, else the oxy- 
gen will escape, and it will be powerless. If when using, the white foam does not ap- 
pear, it is because the preparation has lost its strength, and is absolutely of no use, of no 
more value than so much water, H 2 2 must be present. It is the additional atom of 
O combined with the H, that does the work, by giving up that nascent O for the pur- 
pose of oxidation. The strength should be 15 volumes. The preparation which I 
always use is Marchand's Peroxide of Hydrogen (medicinal). 



GLYCOZONE IN THE TREATMENT OF GASTRIC 
TROUBLE. 

(Extract from Doctor s Weekly, October 29, 1892.) 

Editor of Doctor 's Weekly: 

Dear Sir. — I received your paper this morning and was pleased to see a notice of 
glycozone. I have used it recently with great success in two cases of gastric trouble 



io8 

-when almost all the useful remedies had failed, and with the happiest results. It is a 
perfect antiferment, relieving all the distressing dyspeptic trouble and aids digestion 
better than all the pepsins I have ever seen. Respectfully, 

Oliver D. Nostrand. M. D., 
Cincinnati, C» Oct. 22, 1892. 286 West Fourth St. 



PEROXIDE OF HYDROGEN AND ITS USE IN EAR 
DISEASES. 

By WALTER B. JOHNSON, M. D., Paterson, N. J. 

Surgeon to the Paterson Eye and Ear Infirmary. 

(Published by the Journal of the American Medical Association, October 29, 1892.) 

The peroxide solution may be used advantageously in the treatment of mastoid 
disease after an incision has been made. The action of the remedy upon bone denuded 
of its periosteum, and even upon carious or necrotic bone, is unique; it causes a disin- 
tegration of the molecular particles, and they are gradually subdivided and carried away 
in the frothy product of the chemical action, until a healthy surface appears upon which 
the solution seems to have only a beneficial effect. The action of the solution upon 
dead bone can be readily demonstrated by placing a small portion of necrotic bone in it; 
the bone in a short time will begin to disintegrate and continue to do so until it is 
entirely divided into minute particles. 

In some of the cases of mastoiditis treated, in which the denuded surface was very 
extensive, in from three to six weeks the bone would be in a perfectly healthy condition, 
the discharge of pus controlled, and the subsequent closing of the wound, when allowed, 
•occurred rapidly and was perfectly satisfactory. 

In one of the cases, in which for three years any attempt to allow the closing of the 
sinuses would be followed by an exacerbation of the inflammation, the carious condition 
was relieved and the opening allowed to close after two months of treatment. 

The treatment is very simple and consists in syringing through the opening and 
into the meatus with a small glass syringe a sufficient quantity of the fifteen-volume 
solution, at each sitting, to render the pus thoroughly aseptic, then packing the ear and 
the wound lightly with strips of sheet lint or gauze thoroughly soaked in the same solu- 
tion, great care being taken to allow the wound to close, although the packing must not 
be so introduced that it will prevent the free exit of any pus which may be formed 
during the interval between the dressings. The external incision should be made ample 
and if the packing does not prevent the opening from closing during the progress of the 
treatment it must be reopened with the knife. Glycozone has been suggested for use in 
keeping the wound open, being used instead of the Peroxide in the dressing. 

The result of this line of treatment, which has been followed in a considerable num- 
ber of mastoid cases, has indicated the possibility of a degree of conservatism in the 
treatment of mastoid disease which is very desirable. 

All the cases treated have done well, no deaths have occurred, and in no case was it 
considered necessary to scrape the bone or to remove any portion of it, while the period 
of time necessary for the wound to assume a sufficiently healthy condition to render it 
advisable to permit it to close, did not seem longer than the time which must ordinarily 
elapse after the operation for thoroughly scraping the mastoid, and was much shorter 
than the time required before the wound produced in chiseling the mastoid could possi- 
bly be allowed to close. 

Special care should be taken to keep all the applicators or sprays, used either with 
±he Peroxide of Hydrogen solution or Glycozone, perfectly clean, especially in case of 



109 

mixtures of glycerine and Peroxide, which should be made fresh every second or third 
day, to prevent the possible formation of formic acid; only silver, hard rubber, glass or 
porcelain, should be used for measuring purposes. 

If care is taken to properly keep the solutions, they are perfectly harmless and cal- 
culated to be of inestimable benefit to all who use them. 



THE OPERATIVE TREATMENT OF FISTULA-IN-ANO. 

By LEWIS H. ADLER, Jr., M. D., 

Adjunct Prof ess 07- of Diseases of the Rectum, Philadelphia Polyclinic and College for 

Graduates in Medicine. 

Read before the Phila. County Medical Society, November 23, 1892. 

(Reprinted from the International Medical Magazine for October, 1892.) 

THE AFTER-TREATMENT. 

After the operation of fistula in ano, I am in the habit of packing the wound with 
iodoform gauze, which is left undisturbed for twenty-four hours. This is done to pre- 
vent subsequent hemorrhage. A pad of gauze and cotton and a T-bandage are next 
applied. 

The subsequent dressing of the case should be daily attended to by the surgeon 
himself. The parts should be kept perfectly clean, and the wound syringed with 
Peroxide of Hydrogen (Marchand's), carbolic acid solution, etc., after which a single 
piece of iodoform gauze laid between the cut surfaces of the wound will be all the 
dressing required. 

In the after-treatment of these cases I have seen the healing process greatly retarded 
by the excessive packing of the wound with lint, or delayed by the undue use of the 
probe. Such interference is to be avoided. 

If the granulations are sluggish and the discharge is thin and serous, it will be well 
to apply some stimulating lotion, such as Peroxide of Hydrogen, or a weak solution of 
copper sulphate (two grains to the ounce). 

The surgeon should be on the watch during the healing process to avoid any bur- 
rowing or the formation of fresh sinuses. Should the discharge from the surface of the 
wound suddenly become excessive, it is evidence enough that a sinus has formed, and 
a careful search must be made for it. Sometimes it is under the edges of the wound 
that it commences, at other times at the upper or lower ends of the cut surface, and 
occasionally it seems to branch off from the base of the main fistula. 

Pain in or near the seat of the healing fistula is another symptom of burrowing, and 
when complained of, the surgeon should carefully investigate the cause. 

After an operation for fistula, the patient's bowels should be confined for three or 
four days, for which purpose opium is usually given. At the end of this time the 
bowels may be opened by the administration of a dose of castor oil, and so soon as the 
patient feels a desire to go to stool, I am in the habit of ordering an enema of warm 
water to be administered, which has a tendency to render the faeces soft and fluid and 
hence to make their passage easier. The patient should be kept in a recumbent pos- 
ture until the fistula is healed and until the bowels are moved; the diet should be liquid 
such as milk, beef-tea, and broths. The time required for a patient to recover after an 
operation for fistula in auo varies with the extent of the disease. In an average case it 
will be necessary to keep the patient in bed for two weeks, and confined to the house 
for a couple of weeks longer. 



ABSTRACT FROM A TREATISE ON DISEASES OF THE 
RECTUM, ANUS AND SIGMOID FLEXURE. 

By JOSEPH M. MATTHEWS, M. D. 

Prof, of Principles and Practices of Surgery, and Clinical Lecturer on Diseases of the 
Rectum; Kentucky School of Medicine, Louisville, Ky. 

Page 188. — After the operation is performed, Dr. Matthews writes as follows: 
I then syringe the cavity out freely with a solution of bichloride of mercury (i to 
5000). Then a tent made of ioioform gauze is introduced into the cavity, just as much 
as it will hold. After the expiration of twelve hours, I withdraw the iodoform gauze 
and allow any accumulation to pour out freely. I have used the bichloride solution 
heie first, because I believe it to be a good antiseptic and at the same time a good stim- 
ulant to the cavity. However, afterward I substitute another agent — viz. , Peroxide of 
Hydrogen. Of course our great object in dealing with cavities of this kind are two- 
fold: First, to stop suppuration; second, to heal the diseased structure. For prevent- 
ing suppuration, we have chiefly relied upon solutions of bichloride of mercury and car- 
bolic acid. Every surgeon is well aware of the fact that dangers attend the use of car- 
bolic acid in the treatment of suppurating diseases, and the too free use of the bichloride 
of mercury in large suppurative cavities might not only cause too much inflammatory 
action, but also produce a general effect upon the system which would be shown in 
ptyalism. We have in a strong solution of Peroxide of Hydrogen a substitute for these 
two without any of their attending dangers. Undoubtedly the best preparation of this 
agent is Marchand's Peroxide of Hydrogen (medicinal). His fifteen-volume solution 
will retain active germicidal power for many months, if kept tightly corked in a cold 
place. It can be used, of course, in any strength that the surgeon desires. Marchand 
has devised a hand atomizer and ozonizer for the purpose of using the agent in an easy 
manner. 

The abscess cavity is injected once a day with this agent, either pure or diluted 
with water, from three to ten parts, and each time the tent of iodoform gauze is pushed 
gently into the external opening, but not so as to fill the cavity. As the healing pro- 
cess goes on, a less amount of gauze is used. If large rectal abscesses are treated in 
this manner, the number of cases of fistula will be greatly reduced. 



SOME OF THE USES OF PEROXIDE OF HYDROGEN IN 
GENERAL SURGERY. 

By THOMAS H. MANLEY, M. P., New York 

(Published by the New England Medical Monthly, Dan bury, Conn., Dec, 1892.) 

Since Marchand placed upon the market a pure, unadulterated Peroxide of Hy- 
drogen, and Morris, of New York, called attention to the marvelous power of this 
preparation as a deodorizer, the profession have very generally employed it in such 
pathological conditions as will enable us to apply it directly to the diseased surfaces. In 
general medicine it has been employed on an extensive scale in the phagedenic, sore 
throat of malignant scarlatina, diphtheria, and other maladies. 

In surgery, it has been particularly recommended in non-malignant, suppurating 
sores. 

Since it has now come to be very generally known, that with very few exceptions 
all chemical solutions of sufficient potency to kill germs, possess such irritating proper- 
ties as to interfere with healthy cellular proliferation, there has been a demand for 



Ill 

something which might nullify germ activity, and at the same time in no way interfere 
with the recuperative energy in the histological elements. In a large class of cases 
Peroxide of Hydrogen seems to provide this want. 

In the Harlem Hospital and Dispensary service, the Peroxide, Marchand's medi- 
cinal, is largely employed; and, in appropriate cases, with better results, than ivith any 
other agent. 

It seems to possess a special affinity for the lethal elements, in all suppurating pro- 
cesses, which tend to run into chronicity. 

We have largely employed it in those cases of fistular sinuses, so seriously resulting 
from suppurating lymphatic glands in children and adults; as well as in those buboes 
which are sure to heal and discharge, for a long time, a sero-purulent matter. 

The only class of sinuses in which its use should be employed with caution, are 
those in which the fistula extends into a lesion in the osseous elements. 

In many cases, in which a long, deep rent has been made in the tissues, in stru- 
mous subjects, in which healing processes are delayed, its employment is very satisfac- 
tory in effecting primary union. Now, whether it acts as antiseptic; or, by imparting 
fresh vitality to the cells, is a question by no means settled. 

When we use it, it should be applied in such strength as different cases require. 
In foul-smelling, copiously discharging processes, it may be used in a concentrated 
form, while Jn milder cases, particularly in children, it should be diluted. 

In my own private practice none has given me so much satisfaction as that manu- 
factured by Chas. Marchand, and as we have seen in Dr. Squibb's "Ephemeris," for 
this year, the preparation seems to be regarded by chemical analysis, to maintain a high 
and uniform standard of strength and purity. 



INTESTINAL OBSTRUCTIONS. 

DIAGNOSIS AND TREATMENT. 

By FREDERICK HOLME WIGGIN, M. D., New York. 

Attending Surgeon City Hospital, Blackwell's Island. 

(Extract from the Medical Record, July 23, 1892.) 

Irrigation of Abdominal Cavity. — As to the irrigation of the abdominal cavity, 
the practice inclines toward the use of plain water or so-called natural salt solution, six- 
tenths per cent. My own experience and observation lead me to believe that many of 
the complications following laparotomy can be traced directly to the use of chemical 
solutions during the operation, either for irrigation, for disinfecting the hands of the 
operator, his instruments or sponges. In a case where the abscess is circumscribed, it 
is bad practice to irrigate, owing to the danger of infecting the general cavity. In all 
aseptic cases irrigation should be avoided. When irrigation is necessary, while the nor- 
mal salt solution is best, still, in some cases, I believe this may be followed by a second 
douche containing a small quantity of hydrogen dioxide, I have used it for several 
years in all kinds of surgical work, and once in the general abdominal cavity, in a case 
already alluded to (the patient dying shortly after the operation, no deduction can be 
drawn from it), and where pus was present, have found it in proper solution more effi- 
cient and less irritating than anything else. In some of the New York hospitals it has 
been used for irrigating the pleural cavity in empyema, and it has proved satisfactory. 
I have been unable to find any record of a case where this compound has been used for 
irrigating the general cavity. In the letters already referred to, Dr. Sennsays: "Have 
used the hydrogen dioxide in cases of limited peritonitis, and should not hesitate to use 
it in the diffused form " 



112 

Dr. Mann says, "And I have never used hydrogen dioxide in the general cavity,, 
but have applied it to the cut ends of tubes, holes in the intestines and bladder, etc., 
with good results." 

Dr. Clement Cleveland says, "I have never used the dioxide in the peritoneal 
cavity. I have used it pure in the uterine cavity, in puerperal septicaemia, with excel- 
lent results." 

Dr. Robert T. Morris writes, "In localized septic peritonitis, where I have occasion 
to expose directly the affected locality with retractors. I pour in the H 2 2 in full 
strength and without any warming whatever. After allowing it to remain for a minute 
or two I sponge out and repeat, leaving the second lot for five minutes, sometimes not 
removing it all, but putting my gauze wick down into it, and allowing it to be sucked 
up at leisure by the drainage wick. I have used it twice only in general septic peritoni- 
tis. One of the cases was an appendicitis (perforated), with the patient moribund at the 
time of application of the H 2 2 , 1 poured in a very large quantity, enough to bathe all 
of the abdominal organs; a very little hot water was poured into the peroxide just at the 
moment of using it, to 'take the chill off.' The peroxide was then siphoned out and the 
patient was made very much easier by the treatment, although he finally died. The 
other patient died too. The case was one of general septic peritonitis that had gone on 
to suppuration after removal of a gangrenous ovarian cyst. The post-mortem examina- 
tion showed that the H 2 2 had cleansed thecavity beautifully, and although my patient 
died, I nevertheless obtained the impression that one has after such observations, that 
the H 2 2 was very useful, and evidently harmless in itself. There are lots of cheap 
peroxides on the market that contain acids, and such would be harmful." (See article 
by Robert T. Morris, page 72, also article by Dr. H. F. Wiggin, page 92.) 



PEROXIDE OF HYDROGEN. 

By L. C. SCHUTT, M. D., Toledo, Ohio. 

(Published by the Toledo Medical CompenJ, December, 1892.) 

Referring to Peroxide of Hydrogen (medicinal) Dr. Schutt writes as follows: 

Diphtheria — As a local application in this disease, Marchand's Peroxide of Hydro- 
gen (medicinal), can be used full strength, but in the majority of cases it is better to dilute 
it with from 20 to 30 per cent, of water. It may be applied with a brush or atomizer, 
and used as often as the severity of the case may require. 

Pitting of Small-Pox. — The topical application of peroxide of hydrogen or glyco- 
zone is very beneficial. It allays the irritation of the skin and lessens the pitting and 
force of the disease. 

The local application of the peroxide in hay fever has proven very beneficial when 
mixed with an equal quantity of water and glycerine. It should be used at the very 
outset of the disease. 

As a Cosmetic. — When applied to the face it will make imperceptible a dark downy 
growth on the face when the hairs are numerous and fine and cannot be removed by elec- 
trolysis. It should be applied several times a day with a camel's hair brush until the 
hairs are thoroughly whitened and after that as often as necessary. The grease which 
adhers to every hair should be removed by applying a solution of powdered borax in 
water. 

In deep cuts and ulcers you will find the greatest benefit from the use of peroxide of 
hydrogen. 

I will report one case in which very decided benefit was obtained from the use of this 
preparation. 

Mr. P. O. H., a young man 23 years old. He received an injury to his right hip, 
while helping to unload a cannon. It terminated in hip-joint disease, which confined 



H3 

him to the house for more than a year. Finally suppuration occurred, leaving him with 
two sinuses and several openings. All kinds of washes were used but the pus kept up. 
At last I commenced treating it with peroxide of hydrogen, using it pure and diluting it 
with water. We used it every day for seven months at which time all discharge of pus 
had stopped and the openings nearly closed. I am sure no other bactericide could have 
been used so long and with such good results, without injury to the parts or general 
system. 



SURGICAL MEASURES OF RELIEF IN STENOSIS OF THE 
UPPER AIR PASSAGES.* 

By THOMAS H. MANLEY, M. D., New York. 

During the past ten or fifteen years the discussion of the etiology, pathology and 
surgical treatment of stenosis of the aerial passages, particularly in children, has occu- 
pied an important position in medical literature, both home and foreign. 

Yet with all that has been written on this subject, it must be admitted that the 
profession is in anything but accord on the most appropriate measures, either prophy- 
lactic, or remedial, in those maladies which jeopardize life through impending asphyxia 
or apncea. 

It was hoped with the application of the invaluable apparatus of Dr. O'Dwyer that, 
at last, the most formidable obstacles in the way of treatment had been forever removed; 
that the scalpel and tracheal tube might be laid aside, and that hereafter relief-measures 
would be as prompt and bloodless as they were efficient and permanent. 

But it was soon discovered that, like every other relief-measure, intubation has its 
limitations; that there is a considerable proportion of cases in which the perforated, 
laryngeal plug may, when introduced, destroy every possible prospect of recovery. 
Our aim should be in all cases, to occupy a middle ground; as neither too zealous par- 
tisans of the one, nor uncompromising foes of the other. Some would impose so far on 
the credulity of their brethren as to have them believe that intubation is the sovereign 
remedy when applied early and skillfully. Others there are, who have cast it aside alto- 
gether. Of this latter I saw a practical proof in the Princess Augusta's large ward for 
children in the Frieriechshal-Hospital in Berlin. Here their experience with intuba- 
tion had been so unfortunate that they had discarded it altogether. Hence, while we 
all agree that divulsion of the laryngeal chink through the buccal cavity occupies an 
important place in surgical therapy, it constitutes but one of our resources. In the con- 
troversial side of the question, it is not my purpose, at this time, to enter. 

The conditions that give rise to a mechanical impediment to respiration in the upper 
air passages are dependent on inflammation — infectious, specific, neoplastic and 
traumatic. 

The fundamental principle underlying every phase of treatment, of whatever de- 
scription instituted, is to secure a patent air-passages until nature has removed the bar- 
riers to normal respiration. To most safely accomplish this purpose we must depend 
chiefly on three agencies: First, on constitutional treatment, which is more or less appli- 
cable in all phases of laryngeal stenosis; second, on local medicative measures, third, 
on surgical invention. 

As the surgeon's aid is seldom invoked until the time is past for internal medica- 
tion, only the second and third of these agencies will be considered here. 

For the first of them, there are but two substances with which I am acquainted, 
that possess such properties as will commend them in the majority of cases. I may add 

♦Read before the Section of Paediatry, Academy of Medicine, New York, Feb. 9, 1893. Pub- 
lished by The Medical and Surgical Reporter, of Philadelphia, Pa., Feb. 25, 1893. 



ii4 

parenthetically, that unless the patient is on the border line of the moribund state, local 
measures should be pressed with energy for a short time before surgical intervention is 
resorted to. 

Mercury pre-eminently occupies the first position. First, because of its well known 
power as an antiseptic agent; and secondly, for its effects on the general system when 
taken up by absorption through the mucous membrane. It may be administered by 
fumigation — when calomel is incinerated; or through the spray — when we employ the 
bichloride solution of a strength varying from 1:500 to 1:3000 according to the age of 
the patient, its impression on the system, or the urgency of the symptoms. The objec- 
tions to the employment are the possibility of ptyalizing the patient or salivating the 
nurse or attendant. Besides, though this agent possesses active bactericide powers, it 
it not a deodorizer. 

In many cases of an infectious or gangrenous character extending into the larynx 
or trachea, the ideal solution is one which is gentle and simple in its application, but 
energetic in action; one best tolerated and possessed of the greatest affinity for the ne- 
crotic residue of diphtheritic or other inflammatory products. To attain this end there 
is nothing with which I am familiar, which may be administered so continuously as the 
peroxide of hydrogen medicinal. 

An eminent medical authority* has recently warned the profession not to use this 
agent in throat troubles, because, as he alleges, it may cause diphtheria itself. This view is 
totally at variance with clinical experience and with our knowledge of the fundamental 
etiology of the disease; though we must concede, if an inferior quality be used, or it is 
employed in too strong solution, an exudate is formed, but this exudate must be rather 
attributed to its injudicious employment than to any inherent power of the drug to pro- 
duce such exudate. In all cases, when we employ this gaseous agent we should be 
assured of its purity and standard strength; hence it is my custom to employ Marchand's 
medicinal, alone, when it can be secured. The inhaler which goes with this medica- 
ment, in my hands, in the hospital and elsewhere, has served an admirable purpose in 
pharyngeal or laryngeal affections. '"The immense number of unsophisticated medical 
men all over this country whose anxiety is for new and effective remedies, and who are 
stimulated by these miserable surroundings"! may be safely trusted with the best and 
safest in the matter of chemical solutions, as in the selection of wines, meat juices, pro- 
prietary medicines or other pharmaceuticals. 

When it appears futile to persist further with local applications, and the symptoms 
of approaching asphyxia are urgent, the time has arrived for prompt surgical interference. 
It is well known that in tracheotomies the results following, depend mainly on two fac- 
tors, viz: the violence of the constitutional infection, and the manner in which the oper- 
ation for relief is performed. The former is beyond our control, but not so with the 
latter. For, with the aid that modern surgery has placed within our reach, the techni- 
que of opening the air passages above the sternum has been greatly simplified. The 
elder Gross regarded tracheotomy as one of the most formidable operations known to 
surgery. 

The dangers immediately connected with the surgical technique of a tracheotomy 
are: 

(1) Those which have reference to pulmonary anaesthesia. 

(2) Hemorrhage. 

(3) Shock. 

With every one who has ever administered an anaesthetic, or seen it given to one 
with an embarrassed respiration, it is needless to rehearse here the difficulties in the way. 
In the first Stage of anaesthesia the little one struggles and strangles so that the anaesthe- 
tizing agent must be given intermittenly. As the second stage or anaesthesia is reached 
a deep cyanosis sets in. With the accession of the third stage the corneal reflexes are 

*Dr. A. Jacobi, Note on Peroxide of Hydrogen. Archives of Pediatrics, Dec, 1892. 
^Ibidem, 



"5 

paralyzed and the asphyxia deepened so that the operator is warned to hasten on or 
death will quickly end the scene. But our patient is a child, and it is a matter of com- 
mon observation that children, proportionately to their age, take a large quantity of 
anaesthetics and come from under their influence very quickly. Hence, under the cir- 
cumstances here considered, the circulation already toxemic must be further super-sat- 
urated with another lethal agent, and along with this, the fear of the patient's returning 
consciousness hurries the surgeon on with the procedure in which it is always imperative 
to proceed with caution and deliberation. Anaesthesia is, it must be admitted, one of 
the positive dangers in opening of the trachea. 

Without question the next difficulty in this operation is profuse hemorrhage. Here 
the escape of blood is dangerous in a dual capacity. First, through mortal anaemia, 
and next through leakage into the trachea inducing fatal asphyxia, or by being sucked 
into the bronchial radicles and causing septic pneumonia. As the trachea in the child is 
deeply lodged beneath an immense network of blood vessels which lie immediately under 
the skin, the deep cervical fascia and over the thyroid isthmus, the division of the deeply 
situated parts is not unlike the splitting of a saturated sponge. Nevertheless, if ample 
haemostatic precautions are observed, after the first gush in penetrating the deep cervical 
fascia, it will be slight and neither will annoy the operator nor endanger the patient. 

In May, 1890, Paul Reclus, in the Gazette Hebdomadaire, published his remarkable 
contribution on "Cocaine Analgesia." The year preceding, Prof. W. W. Dawson had 
presented an able essay entitled "Bloodless Tracheotomies."* Although Reclus re- 
ported more than two hundred cases in which he had successfully operated under cocaine, 
he mentioned none for tracheal stenosis. After I had carefully read the essays of both 
the Ohio and the French surgeons, it occurred to me that, by a combination of both ex- 
pedients, the ideal tracheotomy operation was at last secured. Within one month of the 
publication of Reclus' essay I was favored, at the Harlem Hospital, with an opportunity 
of testing for the first time, and estimating the full value of, a surgical procedure which 
I have designated "Tracheotomy by the Reclus-Dawson Method." 

I, personally, claim nothing for myself in connection with this invaluable device, 
save in evolving a new operation by a combination of analgesia with haemostasis, and 
priority in being the first to operate by this method and to publish its history and tech- 
nique. This I did in the Journal of the American Medical Association, i8gi. 

Though I have had four opportunities of employing it in the adult, up to this time 
I have had but one child, an infant, on which to test its merits. This was a patient of 
Dr. Murray's, but two months of age, which was suffering of submucous tubercular ab- 
scess of the larynx. All my patients recovered. 

In a nutshell, its technique is as follows: Rigorous antisepsis; a one per cent, solu- 
tion of hydrochlorate of cocaine hypodermically administered after Rectus' plan; the 
drug hypodermically employed, never to exceed the maximum dose by the mouth. I 
always douche the surfaces of the integument, either by a spray from a siphon of carbon- 
ated water, or else pure cold water from a height which accomplishes the same end, be- 
fore I make the first incision. The cocaine injection serves a triad purpose in these 
cases; first, as an analgesic; secondly as a cardiac stimulant, and thirdly, as a styptic or 
haemostatic. In these cases which we tracheotomize for infectious or acute inflamma- 
tory obstruction, and in which patency of the opening is but a temporary expedient, I 
am confident that the best tracheal tube is none at all. In this infant of two months, 
by passing two sutures through the divided tracheal walls on either side an ample air 
vent was effected. 

I am confident that as the new procedure is more generally adopted, tracheotomy 
will regain its lost ground. For by it, when it succeeds, deglutination is not interfered 
with, perfect drainage is secured and the inconvenience and danger always attendant on 
tubation of any description, is obviated. It is unnecessary to add that by it, too, the 
dangers of collapse and shock will be minimized. 

*Jour. Amer. Med. Ass'n., July 13, 1892. 



DISCUSSION ON DR. MANLEY'S PAPER. 
(Reported Stenographically by J. J. Sullivan, M. D.) 

Dr. Chaffee, of Brooklyn, said that he believed that if Dr. Manley's method of 
using cocaine was adopted, it would make tracheotomy more popular than ever before, 
and operators would not have the dread of the operation as they have at the present 
time. Pie was a great admirer of intubation but he never regarded the two operations 
of tracheotomy and intubation as direct rivals. 

Dr. Stewart was very glad to hear Dr. Manley stand up for mercurialism in the 
treatment of diphtheria. He always found that the further he departed from the use of 
mercury in the treatment of diphtheria, the more apt the patient was to die, and he has 
never seen a case of ptyalism in a child with true malignant diphtheria from the use of 
mercury. He still used bichloride in combination with Marchand's peroxide of hydro- 
gen (medicinal) with the best results possible. 

He used a five per cent, solution of Marchand's peroxide of hydrogen in water, and 
about 1-3,000 of the bichloride. He also gave the same drug internally and has had 
much better results than formerly with the old, iron, chlorate of potash and like reme- 
dies. 

Dr. Fruithight said he would like to bear testimony to the good results he has se- 
cured in the treatment of diphtheria by calomel fumigation. He has used calomel fumi- 
gations recently in three very grave cases and they all recovered. He has used as a local 
remedy Marchand's peroxide of hydrogen. 

Dr. Stanton has been using bichloride of mercury in the treatment of diphtheria for 
the past four or five years, and he regretted to say that his experience was disappointing. 
So far as local treatment is concerned, he has used a spray of Marchand's Peroxide of 
Hydrogen, and he has never found any reason to regret its use. He has read the criti- 
cisms of Dr. Jacobi, and he never experienced any such results as he has seen from the 
use of Peroxide of Hydrogen. He, Dr. Stanton, uses a fifteen volume strength of the 
Peroxide, and dilutes it one-half; spraying the affected parts every two hours with it. 

Dr. Dillon Brown stated that his experience with the Peroxide of Hydrogen has 
been the same as Dr. Jacobi's, but he considers this condition referred to, to be due to 
the irritating effect of the acid in the Peroxide of Hydrogen. He still believed that Per- 
oxide of Hydrogen was the best remedy they had in the treatment of diphtheria. 

The way to overcome this acrid condition of this solution was to add to the fifteen 
volume solution, sufficient ammonia to make it neutral, or if they wished to dilute the 
Peroxide, to dilute it with lime water which does not in any way effect its chemical prop- 
erties, and the results are just as good. 

They do not then get those lesions that affect the mucous membrane as described by 
Dr. Jacobi. So used, he considered the Peroxide of Hydrogen the best remedy they had 
in the treatment of diphtheria. The acid he spoke of contained in the solution was sim- 
ply an impurity which it was expensive to get rid of, and consequently more profitable 
to leave in. 

Dr. Manley in closing the discussion said that in reference to the question of Per- 
oxide of Hydrogen increasing the area of the membranous exudation it cannot be denied 
that when they sprayed the throat with Peroxide of Hydrogen, there was a membrane at 
once formed, that is, if they called a deposit of mucus coagulated by the acid of the 
Peroxide of Hydrogen, a membrane, they had such a membrane every time they em- 
ployed the Peroxide, as they would have a membrane if they were to use a strong solu- 
tion of nitrate of silver, but nothing more. 

He regarded intubation as a wonderful thing, but he would emphasize the fact that 
it had its limitations. In intubating the larynx, the great difficulty was the mechanical 
one in getting a tube that will adjust itself to the lumen of the passage. These passa- 
ges are very irregular in form and outline, and if the tube did not fit, it acted as a foreign 
body, giving rise to irritation and necrosis. 



ii 7 

APPENDICITIS. 

By ROBERT T. MORRIS, A. M., M. D., New York. 

A Clinical Lecture at the New York Post-Graduate Medical School, February, u, i8gj, 

(Reprint from the New England Medical Monthly for April, 1893.) 

Gentlemen: 

"How many appendicitis patients have you in there?" I asked when driving by a 
grave-yard in company with a physician, one day last week. "Two of my own and four 
that were seen in consultation," he said. "I was just counting them up when you spoke, 
and I feel that none of them would be there if they could have had timely operations." 

If the grave-stone of every appendicitis patient who need not have died were to give 
out a light, every cemetery in the land would shine at night. 

Before removing the appendices from our two patients this afternoon, I will show 
two fresh specimens which illustrate widely different types of the disease. This first 
wicked looking specimen I removed on Tuesday from a patient who was in the eleventh 
day of an acute general peritonitis. The patient was then moribund. To-day he is re- 
covering. There is always a question as to the policy of operating upon such patients 
but accumulative experience enables us to attack cheerfully the most vicious of cases. 

Up to the year 1890 we lost a good many appendicitis patients after operation, but 
from the vast mass of recent data, we have reduced a few apparently trifling changes in 
technique that give our patients chances for life; changing the whole outlook of these 
operations, just as ideas about peritoneal operations in general underwent a transforma- 
tion a very short time ago. 

Again let us look at this dark and ragged specimen which has been slit along the 
free border to show the interior. A stricture at its middle occludes the lumen. 

The stricture is a hieroglyphic in high relief and we can read it. It says that the 
patient once upon a time had appendicitis, that a bit of mucous membrane was murdered 
-and cast out into the bowel; and that the resulting ulcer filled the gap with a collar of 
connective tissue. 

When the stricture contracted it entrapped two fecal bullets in the distal half of the 
lumen and left the appendix loaded. Last week the bullets went through the wall and 
shot the patient. 

The physician who asked me to see the case was doubtful about its being one of 
appendicitis, because there was no particular pain at McBurney's point and because there 
was no dullness on percussion in the right inguinal region. Nevertheless, he remembered 
my earnestness in insisting that acute peiitonitis in adult males and in children of both 
sexes was a fire alarm calling the surgeon to come quickly and put out the appendix. 
The reason why there was no particularly tender spot and no inguinal dullness was be- 
cause the abdomen was tense and shiny with acute general peritonitis and because one 
of the abscess cavities in the inguinal region was stretched with hissing, stinking gas. 
How did we find it out? We looked! When I had placed the patient in Trendelenburg's 
position and had evacuated a large amount of pus and gas, one of the consultants thought 
we had done enough. After sterilizing the abscess cavity with peroxide of hydrogen 
(Marchand), I proceeded to separate all adhesions and finally came to a large secondary 
oesspool of pus, containing the riddled gangrenous appendix. 

Now the patient can live. 

Don't forget what happened after it was thought advisable to rest content with 
draining the first abscess. 

A word about opium. I am about through with opium in any form in peritonitis of 
any sort. Mr. Tait, I believe, says that he has banished it from his pharmacopoeia alto- 
gether. 

My two definitions for opium in peritonitis are these: 



1. A drug which stupefies the physician who gives it more than it does the patient 
who takes it. 

2. A drug which generally relieves the distress of the physician who without it would 
be compelled to do something rational for the patient who has put confidence in him. 

Opium and peritonitis breed a vampire which lulls the patient to sweet repose while 
his life is being sucked out, and the doctor is looking the other way. Remove the cause 
for peritonitis when you can. Remove the products of peritonitis when you can do noth- 
ing better. Avoid as carefully as possible the teachings of our honored preceptors who 
did the best they could in the days when symptoms were treated and not prevented. 

An abdomen swollen with peritonitis looks to me like a great big ripe boil and need- 
ing the treatment that boils usually receive. 




Figure i. 

Longitudinally split appendix. Perforated by concrements. 
i. Point of exit of fecal bullets. 

2. Old stricture occluding lumen. 

3. Hard, dry fecal bullets. 



Gangrenous. 



Here is the second appendix. It is apparently normal as you observe, excepting at 
the tip where it is rough and clubbed. I removed it last Thursday from a young man 
who three weeks ago was laid up for a week with colic and vomiting, associated with 
swelling and tenderness in the right inguinal region. He found that "something pulled" 
whenever he made exertion, and the tender spot remained. The roughness at the tip 
shows where adhesions fixed the tip of the appendix to parietal peritoneum, and that is- 



ii 9 

what caused the pulling and the tenderness. His appendix is what I call a "growler." 

The first patient of to-day's clinic is ready. The history is briefly this: Shortly after 
childbirth, fifteen years ago, agonizing colic, bilious vomiting, rigors, febrile reaction, a 
lump in the right inguinal region. Acute attacks have recurred several times and of late 
years the lump has been permanent. Intestinal obstruction has lately become a serious 
feature of the case. My analysis of her symptoms is this. At childbirth a foreign body 
in the appendix was compressed until it injured the mucous tube and allowed bacteria to 
enter the adenoid tissue. The colic means that the intestine was trying its muscles on 
disagreeable company, which needed to be forced away. The colic is sometimes awful, 
and always unnecessary, if the surgeon is near. Bilious vomiting means that absorbed 
septic matter was being excreted by the liver, and the ptomaine bearing bile on reaching 
the duodenum mischievously reversed the lever of the duodenum and flooded the stomach 
with bile. A reversed peristalsis caused by certain irritants is familiar to some of you as 
a laboratory experiment. The rigors and the febrile reaction meant that microbe products 
were poisoning sympathetic nerve centers. The inguinal lump indicated that local peri- 
tonitis had welded several structures together in order to protect the peritoneal cavity 
against the company that the intestine was trying to rid itself of. The intestinal obstruc- 
tion means that adhesions have contracted. 

The peritoneal exudates make a lymph cake. Sometimes this lymph cake is a simple 
pound cake, that the peritoneum digests as soon as the appendix has been temporarily 
appeased. Sometimes it is a cream cake, and the pus if not absorbed, finds its way into 
a large vein or into the ureter or into the bladder, or somewhere where no reputable sur- 
geon would think of making an opening. Nature tries to do some surgical work but she 
is a good deal more of a success at making lilies. 

Then again, we are never sure when nature prefers to save the patient or to en- 
courage a particularly fine bed of microbes. It is a pretty conceit for us to assume that 
she cares more for one specimen of homo sapiens than for a whole lot of streptococcus 
pyogenes aureus. The presence of a lymph cake in the vicinity of an appendix vermi- 
formis is the piteous signal of the peritoneum for help, and the sympathetic surgeon must 
respond instantly, bearing in his hand the little wand that will vanquish the witch. A 
diseased appendix which is not walled in.with lymph cake needs equally prompt attention 
by the surgeon. 

Under procrastinating medical treatment by the good physician, a surly appendix 
may often be coaxed back into its hole where it mutters and sulks and prepares for an- 
other spring at the patient. 

Our patient is now placed in Trendelenburg's posture. The reason for that is, be- 
cause we do not want to play a jack-in-the-box game with intestines, but prefer to attend 
strictly to business. Another reason is because we wish to have pus run out instead of 
running in. Another reason is because one look at the involved parts is better than two 
feels and four guesses. The side of the appendix is exposed through the customary lat- 
eral incision. The lump is found to consist of a heterogeneous mass of omentum, 
mesentery and ileo-caecal intestine, and firmly welded together. When the bass are biting 
fast and my line gets into this kind of a snarl I cutout the whole snarl at once and throw 
it away. I believe that we must do that in some cases of these old appendicitis with in- 
testinal obstruction, but I have succeeded in undoing so many similar snarls that we will 
try it once more. Guided by the small granular lumps of fat we separate the adhesive 
omentum. That is easy. Guided by the direction of the blood vessels, we separate the 
adhesions of the mesentery. That requires sharp eyes, for the bowel as usual rolled itself 
up in mesentery when it first became frightened. Guided by the direction of muscular 
tissue we slowly work the iluem free. Here comes a sudden burst of pus which runs out 
upon the abdomen because of the Trendelenburg's position. The abscess cavity is irrigated 
with peroxide of hydrogen (Marchand). This is done because the peroxide is a search- 
ing sterilizer and it throws pus and debris out of nooks and crannies. It is easy to ob- 
serve that the appendix is practically gone into solution in the abscess cavity, and here I 
find a piece of apple core encrusted with phosphates that has caused all the trouble. The 



caecum has disappeared. It was drawn up by adhesions, strangled, and forced to join 
the abscess. There is no ileo-caecal valve but in its place a rigid, narrow, tortuous chan- 
nel about five inches in length. 

Gaze upon this wreck of vitals, produced progressively by successful attacks of ap- 
pendicitis, and then consider the responsibility of the physician who in appendicitis 
cases advises the patient to wait. How easy an early operation in this case! How 
desperate the operation now! I ought to respect the intestine right here, but the 
patient has been absorbing pus for several months so I will make a fecal fistula to relieve 
the ileum, and resect the intestine a month later. The shock we will treat with nitrate of 
amyl to the nose at first and then hypodermic injections of nitro-glycerine and strychnine, 
together with the routine resources of hot bottles, hot rectal injections and elevations of 
the legs. 

Our next patient is genial Dr. Robert Kennedy, Jr., of proteinol fame, whom 
most of you know. Judging from his appearance he has never lived upon anything more 
artificial than a thick tender porter house steak. His appendix must come out, however. 
Two years ago after exposure to cold sea winds, the Doctor was suddenly attacked with 
colic and abdominal cramps, but at the end of a week was practically well again. Eight 
months ago he was again attacked in the same way, but with added symptoms of rigors 
and vomiting, together with pain and tenderness in the right inguinal region. After sub- 
sidence of the acute symptoms there remained a persistent feeling that something was 
wrong with the appendix. He was constantly inclined to press with his hand over the 
region of the appendix and found discomfort in certain positions when sitting. That 
is a pretty good history of early infectious appendicitis. 

After his history had been taken, our conversation was something like this: 

Q. Well! What do you advise me to do about it? 

Ans. That depends. If you are always where good medical attendance is within 
easy reach, it would be as well to pay no particular attention to the appendix at present. 

Q. But I travel a great deal, and am liable to be caught with an acute exacerba- 
tion at any time and place, am I not? 

Ans. Certainly. 

Q. Is the next attack likely to be more severe or more mild than the last one? 

Ans. No one can possibly predict! 

Q. Is sloughing or perforation as likely to occur in the third attack as in the 
tenth one? 

Ans. Surely! 

Q. Can I recover completely and have no further trouble without an operation? 

Ans. Yes! 

Q. Am I likely to? 

Ans. No! 

Q. What are the dangers of an operation now? 

Ans. I have never been anxious for my patient no matter what the complications 
were, excepting in desperate cases with pus and septicaemia to deal with at the time of 
operation; when these two features were absent the technique which buries the stump 
of the appendix and which ensures against ventral hernia later has given me perfect ease 
and comfort in a responsible position, and the patients have made uninteresting re- 
coveries. 

Q. The greatest danger from the surgeon, then, is when there is greatest danger 
from the disease? 

Ans. A la bonne heure! 

Q. Well, I like the opposite combination better! If by having my appendix cut 
now, I can escape the ever present dread of exacerbation and can save the time lost in 
attending to mild attacks. If you do not now dread the operation and if you will dread 
it when I am in danger from the disease, why is it not good business judgment to decide 
that the appendix should come out? 






121 



Ans'. That is for you to say. I am at your service. 

Q. When will you take it out? 

Ans. On Saturday, 4.30 P. M., if you are willing to go before my class at the 
Post-Graduate Medical School. The matriculates have shown unusual interest in my 
appendicitis cases there. 




Figure 2. 

Final. All right! Glad to give them points! I'll be there! 

And here he is. A man in fine health, suffering only a little discomfort, deciding 
to have his infectious appendix removed as a plain matter of forethought and discretion. 




Figure 3. 

The patient being placed in Trendelenburg's position my incision is made over the 
normal site of the appendix. The incision is about two and a half inches long, through 
skin and muscle and about one and one quarter inches long through transversalis fascia 
and peritoneum. Intestine presents, I see by the longitudinal band that it is colon. 




Figure 4. 

Transverse section of longitudinally split appendix. Moderate exudation. 

1. Mucosa and adenoid coat bulging a little. 

2. Submucous connective tissue thicker than the combined muscular and peritoneal coats. 

3. Muscular and peritoneal coats. 

Passing it through the fingers in a direction which will put the csecal peritoneum upon 
the stretch, we soon come to a halt. The appendix must be very near. Here is its base 
presenting in the wound. I pull the appendix out through the opening. It is about 



five inches long-, hard and congested. While an assistant holds it with forceps, the 
mesentery of the appendix is ligated with cat gut and divided, the peritoneal and mus- 
cular coats of the appendix are clipped through at the caecal junction. The mucous 




Figure 5. 
Transverse section of longitudinally split appendix. Exudative. A "pop corn" appendix. 

1. Mucosa and adenoid tissue bulging prominently. 

2. Submucous connective tissue much distended. 

3. Combined muscular and peritoneal coats. 

tube is ligated well down into caecal mucous membrane with the finest of eye silk. The 
peritoneum of the caecum about the base of the appendix is scarified with the point of a 
needle until pink serum exudes, and those of us who are accustomed to experimental 




Figure 6. 
Photo-micrograph of transverse section of infectious appendix of Dr. K. Mucosa, x 50. Intense 
round cell infiltration. No epithelium remaining. 

abdominal work in the lower animals, realize that this is one of the most important 
points in the technique, and must never be neglected in cases like this one. The mu- 
cous tube is stripped away, leaving a trifling stump. Four Lembert sutures of cat gut 



123 



bury the stump. If the silk ligatures and its tiny stump must escape for any reason they 
would go into the lumen of the bowel. The relative position of sutures after this 
method of suturing, is shown in Figure 2. 

The method of ligating which is apt to leave an Esquimaux window at the site of 
the appendix is illustrated in Figure 3, and I should have no confidence in such a scar. 

In closing the wound of the abdominal wall, peritoneum and transversalis fascia 
and transversalis aponeurosis receive one tier of silk worm gut sutures. Internal oblique 
and external oblique aponeurosis each receive a separate tier of silk gut sutures, the 
knots to remain permanently, and skin and fat are honored with a cat gut tier. This 
patient now will not have a ventral hernia. 

Let us examine the specimen removed. As I slit it along the free border you will 
observe that the inner tube hastily bulges out. It is what I call a "pop-corn" appendix, 
and on comparing it with the normal portion of this other appendix the reason for the 
name is apparent. 




Figure 7. 
Same case as Figure 6. Submucous and muscular coats infiltrated x. 250. Other secretions of this- 
same specimen show that the subserous tissue and even the walls of the blood vessels were invaded and 
the lymphatics were clogged with products of this infectious exudative inflammation. 

The condition shown in Figure 5, is, I think, characteristic of infectious appendi- 
citis. This elastic inner tube apparently swells within the outer tight tube until the 
crowding cuts off circulation and then little or big sloughs of mucosa and adenoid tissue 
occur. These either decompose and escape into the bowel, leaving an ulcer; or they 
escape bodily through the wall of the appendix leaving a perforation. That I think is a 
pretty good history of appendicitis no matter whether the infection began through the 
influence of exposure, or foreign bodies, or local tuberculosis, or amoebae coli, nema- 
todes, or typhoid fever, or dysentery. So far as I can learn, authors have not noted the 



I2 4 

fact that patients sometimes depreciate rapidly in health without discoverable cause for a 
week or for several weeks before the first acute symptoms of appendicitis appear. The 
natural explanation is that they are absorbing products of the infectious inflammation at 
the appendix before exudation has swollen the mucous tube enough to make strangula- 
tion. It is sometimes asked how can I reconcile this theory and the condition of dropsy 
of the appendix, in which all structures are widely distended. My answer is: Slow, 
low grade inflammation giving time for dilatation of all structures, and not associated 
with tonic muscular spasm of the muscular wall of the appendix, such as we would expect 
in acute catarrhal inflammation. The theory of causation of appendicitis carried out to 
meet the common principal symptoms, is arranged thus: 
Colic. — Simple vomiting. Right inguinal tenderness, choking of swollen inner tube in 

tight muscular tube which is made more rigid by tonic muscular spasm. 
Colic. — Bilious vcmiting. Right inguinal tenderness. Formation of tiny or large inner 

tube sloughs, and absorption of septic products from the decomposing sloughs. 
Colic. — Bilious vomiting. Right inguinal lump. Oozing through or slow perforation of 

appendix wall by sloughs and other contents, met by lymph exudate from peri- 
toneum. 
Colic. — Bilious vomiting. Collapse. Rapid perforation of appendix wall by sloughs 

and other contents, allowing no time fcr formation fo? protecting lymph exudate. 

The reason why the inner tube is so hard pressed in the tight tube of peritoneum and 
muscle is because of the great round cell infiltration and serous distension. I will ask 
Dr. J. C. Smith to make a section of this infectious appendix in the pathological labora- 
tory and then give us a photo-micrograph. 

It seems strange to me that the life insurance companies pay so little attention to a 
disease which daily claims its large quota of deaths. Patients who have exacerbating ap- 
pendicitis can at present take out heavy policies in anticipation of a fatal termination of 
the malady. The insurance companies will not always discover that a patient has ap- 
pendicitis if the diagnosis which patients bring to the surgeon form any guide. I am 
keeping a record of diagnoses that were made for patients of mine who had typical ap- 
pendicitis, and the list up to the present time includes bilious colic, bilious peritonitis, 
gallstones, typhoid fever, typhilitis, perityphilitis, coecitis, la grippe, abscess of the ab- 
dominal wall, pyosalpinx, ovarian abscess, and psoas abscess. 

I wish the physicians who make the diagnosis of typhilitis, perityphilitis and idiopathic 
peritonitis, could know how farcical such a diagnosis sounds to those of us who have fre- 
quent occasion to look and who find the case to be appendicitis. 

This subject of appendicitis, Gentlemen, is very near to my heart. Friends of mine 
attacked in the prime of manhood are now gone forever, because their physician waited 
to see if they would not get better without operation. When they were a little worse 
consultants were called in, and the consultants gave cheerand hope to the anxious fami- 
lies by describing similar cases of theirs which had made most excellent recovery. Fin- 
ally, when my friends were dead, the physician said: There ! Those were the cases for 
early operation. 

As to the after treatment of these cases I treat cases of appendicitis as I do surgical 
abdominal cases in general, strictly recumbent position upon the back for twenty-four 
hours or more. Hot water to quench the thirst, and practically nothing else for twenty- 
four hours. Sometimes, however, when there is much nausea and giddiness from either, 
it is well to quiet it with a dessertspoonful of effervescing bromo-soda in a half-glassful 
of cold water — not iced. At the end of twenty-four hours begin a diet with proteinol, 
three tablespoonfuls every three hours; then for twenty-four hours proteinol two table- 
spoonfuls every hour and milk four ounces every three hours, giving them separately. 
Watch the effect of the milk carefully. Should its casein curdle in masses causing pain 
and flatulence with irritation, we must not continue to use it raw. 

After about 60 hours, should nothing untoward have happened, the patient may be 
put upon regular diet. Care of course being taken that cold cabbage, pickles, beets, 
cheese and fried foods be omitted. Even at the risk of being monotonous let us keep 






125 

them on plain soups, roast and broiled beef, mutton and chicken; eggs, boiled or in 
plain omeletts; vegetables to be sparingly used unless known to be of no harm, toma- 
toes, potatoes stewed, baked, hash-brown or an gratin, not fried or boiled, lima beans, 
asparagus, etc. Cabbage and cucumbers had better be eschewed. Milk and dry toast 
well done, but not carbonized. But little food should be taken at a time, but often, 
allow all the milk they want, should it agree. As to proteinol the more they take and 
the oftener they take it, the stronger they will be. Always give proteinol by itself, one, 
two or three tablespoonfuls at a time according to the patient's age and inclination. All 
pastries should be denied, puddings well made may be allowed as well as a fair amount 
of fruit, raw or cooked', so as to keep the bowels in good working order. Omitting all 
unripe and distinctly acid fruits that may occasion pain or diarrhoea. 

If the patient has been in the habit of smoking and requests it after about a week, I 
allow it in moderation. The same as regards stimulants. If the bowels have not moved 
on the second day after the operation I advise an enema of soap suds one pint, glycerine 
one ounce, and olive oil one ounce, the whole to be well mixed and injected gently, 
retained as long as possible, then ejected into a bedpan. By no means must a patient 
try to get up or to help himself in these matters. From this on the bowels should move 
each day or every other day; should they not naturally move they should be made to move 
by internal medication. The mildest and gentlest methods must of course be used. It 
goes without saying the room is warm, comfortable and cheerful. The dressings are 
not to be moved as long as the patient has not disarranged them, or pain, fever, and dis- 
comfort generally does not call for it. In about 14 days they can be removed and the 
wound dressed, if pus is present ferret it out with Peroxide of Hydrogen (Marchand's), 
dust with aristol, cover with absorbent sublimated gauze, then a layer of absorbent cotton 
or wood wool, then either use adhesive strips or spica bandage to keep the dressing in 
place, the size and condition of the wound will determine you in this. It is best that 
patients should not sit up in the bed before the 17th day, then for a little while, more on 
the iSth, sitting up beside bed on the 19th, on the 20th a little walking around the 
room is allowed. On the 21st day patients are generally ready to leave the hospital. 

Since the original article was presented for publication the author has completed a series of 
researches which prove that appendicitis is an infectious, exudative inflammation following entrance of 
bacteria into the mucosa and adenoid tissue. The inflammation once begun probably does not stop 
until slow erosion or rapid necrosis cause entire disappearance of the mucosa and adenoid tissue. 
Years may be required for the completion of the infectious process, and in the interval the patient is 
subjected to the danger of poisoning of peritoneum, or thrombosis of mesenteric vessels, of local 
cellulitis, and of various other septic complications. 



PEROXIDE OF HYDROGEN IN THE TREATMENT OF 
GONORRHOEA.— WITH REPORT OF CASE. 

By JOHN J. SULLIVAN, M. D., New York. 
(Published by the Medical Summary for July, 1893.) 

My recent experience with Peroxide of Hydrogen in the treatment of gonorrhoea has 
led me to believe that we have in this agent a most prompt and efficacious remedy. There 
is no doubt that Peroxide of Hydrogen thoroughly destroys the gonococci and promptly 
renders the urethral canal aseptic and free from pathogenic germs. 

Acting upon the theory that antiseptics have the effect of maintaining any cavity or 
canal m the state of asepsis (without being deleterious to healthy tissues), which is the con- 
dition most favorable for the cure of suppuration, I have found by the use of this drug 
that the danger of an extension of the inflammation into the posterior urethra is 
lessened, the course of disease is decidedly shortened, and gonorrhceal complications 
avoided. 



126 

The following plan of treating acute gonorrhoea has proved very gratifying in my 
experience. I instructed the patient to use as an injection three times a day: 

1$ Hydrogen Peroxide, Marchand's, (medicinal,) i oz. 
Aquae dist. , 6 oz. Mix. 

I present a brief history of two cases treated according to this method: 

Case i. — M. S., a married man, aged forty-five years, came tome in great pertur- 
bation of mind, stating that he had recently contracted gonorrhoea from a prostitute. 
He had all the characteristic symptoms of acute gonorrhoea. I gave him the above 
preparation requesting him to use it three times a day, and told him to call again in the 
course of three days, which he did, when I found him completely cured. 

Case 2. — The second case was that of a young man (unmarried), twenty-four years 
of age, who came with gonorrhoea of six weeks' duration. He had tried a host of reme- 
dies prescribed by druggists for the trouble, but in vain. It had gone from bad to worse, 
and made him feel in a very dispondent frame of mind. An examination revealed the 
tissues of the penis to be in a very swollen and painful condition, with a profuse puru- 
lent discharge from the meatus, the lips of which were much inflamed and angry 
looking. He complained of great pain of urination, and was restless at night. I gave 
him the Peroxide of Hydrogen as above, directing him how to use it, and requested him 
to call again in the course of five or six days. When he presented himself five days later 
I found that the inflammatory process was subdued, the pain of urination had disap- 
peared, and the patient expressed himself as feeling in every way comfortable. Ten 
days after this he had reported himself as entirely cured. 

It will be understood, of course, that in these cases I have directed the patients to 
observe the usual rule for diet and internal treatment. 



TREATMENT OF VAGINITIS BY PEROXIDE OF HYDROGEN. 

(MEDICINAL). 

By HERMAN L. COLLYER, M. D., New York. 
(Published by the Annals of Gynecology and Pediatry, oi Philadelphia, Pa., Sept. 1893.) 

There is no disease, aside from the grave maladies so annoying and distressing to 
the patient as vaginitis. The married and single alike may be attacked by it in one or 
another of its varieties, and its treatment by routine methods is slow and unreliable. 

In all its forms, vaginitis starts as do other inflammations, with heat, pain, redness 
and dryness of the parts. The condition is soon followed by slight .swelling of the labia, 
and by a discharge which becomes muco-purulent. Medical advice is usually sought 
after this stage has become established. It was an old-time custom, and is to-day 
observed by some, to order douches, with different mucilaginous substances, and to 
make locaL applications, many of which have wrought harm. The patient was dosed 
meanwhile with various drugs supposed to have a specific effect on the inflamed parts, 
regardless of the causes of this disease. 

Dr. Egbert H. Grandin, of this city, called my attention some time ago to the 
valuable properties of Peroxide of Hydrogen, (medicinal) Marchand's, in cases of vaginitis. 
I then began its use in this disease, whether specific, simple or senile, and have been 
able to cure my cases in a more speedy and effective manner than by other methods. 

It is my custom in the treatment of a case of vaginitis (purulent) first to wash the 
parts with warm creoline water ( 3 ss to Oj), getting rid of all the secretions possible; then 
through a glass or rubber cylindrical speculum to thoroughly wash out the vagina. I 
use peroxide of hydrogen (medicinal) plentifully, either full strength or diluted with luke- 
warm water, and rub the surface with a pledget of cotton, withdrawing the speculum at 
the same time (but not allowing it to come out), so as to allow the peroxide to get deep 



I2 7 

into the crypts, destroying the pyogenic membrane and the gonococci, if any have 
imbedded themselves into the epithelium; I treat the vagina throughout in this manner, 
and also the vulva, especially in the folds of the labia and the orifices of the Bartholin 
ducts. Having destroyed every vestige of the pus with the Peroxide of Hydrogen, I 
pour into the speculum about one ounce. of sol. argenti nitratis ( 3 ss to § i) and coat the 
denuded membrane throughout, inserting a strip of iodoform or aristol gauze to keep the 
parts separated, swabbing the external parts with the same solution (gr. xv to % i). 

I repeat this process every second or fourth day, as the case demands. The patient 
is instructed to remove the gauze on the following day, and to use in acute attacks, a 
cool, weak solution of the lotion plumbii et opii or muriate of ammonia sol. (3 ii to Oi) 
water, two or three times daily. When the symptoms become milder, the use of astrin- 
gents is necessary, as sodii biborat, sulpho-carbolate of zinc or alum. 

In specific vaginitis the endometrium and the urethra have often become affected. I 
treat those cavities in the same manner, of course observing the precautions necessary 
for each, in all cases securing free drainage. 



ETIOLOGY OF THE VARIOUS DEFORMITIES OF HIP-JOINT 

DISEASE. 

By A. M. PHELPS, M, D., New York. 
Professor of Orthopedic Surgery in the University of New York and the New York 
Post-Graduate School and Hospital; Professor of Surgery in the University of 
Vermojit; Surgeon to the City Hospital; President of the American Orthopedic 
Association. 

Read before the American Orthopedic Association, September, 1892. 
(Published by the A"ew England Medical Monthly, January, 1894.) 

We are all familiar with the deformities which occur in the first, second and third 
stages of hip-joint disease. The typical deformities are: In the first, abduction, slight 
flexion, and outward rotation, with apparent legthening (see Fig. 1); in the second, an 
exaggeration of the deformity which occurs in the first (see Fig. 2); while in the third 
stage the entire picture changes to that of flexion, abduction, inward rotation; and real 
shortening, with the toe resting upon theopposite instep (see Fig 3). In a considerable 
per cent, of cases erratic deformities are observed; such as extreme flexion with outward 
rotation and shortening of the affected limb, the deformities of the second stage occur- 
ring in the third. Abduction and shortening, without flexion, is sometimes seen. 

This division into stages is made merely for clinical convenience, and relates only to 
semeiology. 

Barwell says that we may conclude that the appearances indicate certain processes of 
disease, but with morbid anatomy the divison into stages has no direct connection. I 
have adopted this classification of the deformities in my observations and in writing. 

A limb with shortening, from destruction of bone, I classify as belonging to the 
third stage, without regarding the deformities present. A limb with abduction, flexion, 
and inward rotation, I classify as disease in the third stage; even though there be no 
shortening, / have observed in cases excised, that these deformities of the three stages as 
already described, follow very closely, and quite accurately interpret, certain pathological 
changes taking place in, or about, the joint. 

The question under consideration is, what causes these various deformities? 

1. Why does the limb assume, nearly always, the position of abduction, flexion, 
and outward rotation without fixation, in the first and second stages, and abduction, 
flexion, and inward rotation in the third stage? (See Figs. 1, 2 and 3.) 



2. Why, in certain percentage of cases, do the deformities of the second stage 
occur in the third, i. e., flexion, abduction, and outward rotation? 

Barwell makes no attempt to explain these phenomena. I quote from this book:* 
"While the muscles thus waste, the joint assumes a fixed position, natural to itself, 
abnormal only in its persistency toward the side of the flexion. This is the case at the elbow, 
wrist, and ankle, while at the shoulder abduction pertains; at the knee an inward twist of 
the tibia is usually combined with considerable flexion; at the hip very complicated posi- 
tions, to be studied in a futute chapter, are assumed. These postures assume in nearly 





Fig. i. 

every case of joint disease, almost with the certainty of an unchangeable law. There is 
then, in all joint diseases, a tendency of the flexor muscles to contract, while the ex- 
tensors, if not in absolute relaxation, do not, at all events, retract such action." 

."It is true that the flexors are probably, in the limbs, stronger than the extensors, 
but in fact a mere examination will show that on the flexor side muscles are rigid and on 
the opposite side flaccid. Our knowledge is as yet insufficient to account for the 
phenomenon." 

We will consider these statements later. The experiments of the Germans and of 
Edwin Owen, of London, England, demonstrated that the joint, when forcibly injected 

* Barwell, p. 106. Wood's Library, 1881. 



129 

from within the pelvis, produced eversion, flexion, and abduction of the limb and im- 
mobilization of the joint. 

Sayre concludes from these experiments, that effusions are always present in joints 
diseased, that the intra-capsular hydraulic pressure is the cause of the deformity in the 
first and second stages of hip disease. 

He says (his book p. 24S): "The peculinr position of the limb gives to the second 
stage of the disease the name 'apparent lengthening,' but I prefer to designate it as the 
stage of effusion." 

And he accounts for the deformity of the third stage, viz., flexion, adduction, and 
inward rotation, by the rupture of the capsule and the escape of the fluid, thus relieving 





intra-articular pressure. This he claims, allows the legs to swing to the deformity of 
the third stage. He says (p. 259). 

' 'And rupture of the capsule takes place and the imprisoned fluid escapes into the 
surrounding tissues. When this has occurred the disease is in the third stage. 

"The limb is now adducted, inverted, and flexed. 

"The change in position is due to the fact that the fluid in the joint cavity has been 
evacuated. 



130 

"The distension of the capsules, which was the mechanical cause of the flexion and 
adduction of the limb, having been relieved, nothing now obstructs the free action of the 
adductors, and the limb is therefore adducted and inverted." 

So far as I know, this hypothesis of the Germans, approved and indorsed by Dr. 
Sayre, is the only explanation we now have of the etiology of the various deformities of 
the hip-joint disease. Barwell offers none; but makes among others, a broad statement 
that, "It is true that flexors are probably, in all limbs, stronger than extensors."' 

A moment of thought will convince us that this last statement is certainly an error. 

In the knee-joint the quadriceps is much stronger than the flexors. This we have 
demonstrated in the course of our experimental work, and it will be published shortly. 
The same is also true of the hip-joint. The fluid hypothesis is certainly erroneous, for 
the following reasons: 

I-. A very large per cent, of cases of morbus coxarius are unattended by fluid 
effusions. Still, the same picture of deformity is seen as in those cases attended by large 
effusions. 




2. I have observed in our clinics and have operated upon cases of extra-caps ular 
disease, in which the joint 7oas not diseased but the same picture of deformity presented 
itself. 

. Barwell says (p. 292) "While inflammation, or even suppuration about the epiphysis 
of the femur arises, certain pains, forms of lameness, etc., are produced, while as yet 
there is no effusion or suppuration within the joint cavity; no morbid change of the 
parts which form its walls. We have, namely, so-called symptoms of morbus coxarius, 
while as yet in the hip (joint) there is no disease." 



*3* 

3. Cases of suppurating joints with large effusions, often take the erratic deformi- 
ties of the third stage — /.(-."abduction, flexion, and outward rotation — even after the 
joint contents have discharged. 

4. There can be no reason why, after the evacuation of the joint, the limb should 
not return to the deformity of the second stage instead of the third; because the three 





Fig 7. 



Fig. 8. 



great glutei and outward rotators are stronger than the abductor group, unless the limb is 
flexed beyond twenty degrees. These are the chief, and I believe, valid reasons why the 
explanation of these deformities by the fluid hypothesis is incorrect. 



132 



/ have become fully convinced that as yet a correct explanation has not been offered for 
these deformities. 

After concluding several dissections of the hip-joint, I desire to place before you for 
your consideration and criticism the theories and hypothesis upon which we worked, and 
the conclusions at which we arrived. 

It became necessary before any experimental work was performed, to carefully com- 
pile clinical data in a large number of cases. Assisted by Dr. Plymptom and Greenway, 
these observations were made at our clinics at the University Medical College, and also 
at our Out-Door Department and the Orthopedic Ward of the New York Post-Graduate 

School and Hospital, two places 
which afforded us ample opportun- 
ities for observation. The con- 
clusions reached were: 

1. That abduction nearly 
always preceded flexion, or was 
attended by it, in the first stage. 

2. Abduction and outward 
rotation, are always present in the 
second stage. Flexion was nearly 
always present, but was absent in 
a few cases. 

3. When the limb flexed 
beyond forty degrees, and fre- 
quently at a much lesser degree 
(twenty degrees), it quite rapidly 
passed to the deformity of abduc- 
tion, inward rotation, and flexion, 
whether the capsule contained fluid 
or not. (The degrees alluded to 

e from a horizontal plane.) 

4. A few cases exaggerated the 
deformity to the second stage for 




Fig. 9. 
the third. In other cases there was outw r ard rotation, abduction, shortening, with but 
slight flexion in the third stage. (See Fig. 4.) 

In another case observed by Dr. Plymptom, abduction and inward rotation, without 
flexion, occurred with three-fourths of an inch shortening. (See Fig. 5.) 

5. That there was always spasm and contraction of muscles about the joint, and 
in nearly every case all the various groups were in a state of spasmodic contraction. 
That shortening annulled or modified the action of the abductor group. 

These observations, together with dissections which Dr. Greenway and I made, 
presented numerous problems which will be considered later. At the University dissect- 
ing-room, we made a series of dissections, from which I think a fair explanation can be 
given of every deformity which may occur in any case of hip disease. 



*33 



The hip-joint is surrounded on its outer aspect by a mass of muscles running 
diagonally from the pelvis to the great trochanter from all directions. When the limb 
is in a straight position the combined action of these muscles produces abduction of the 
limb. The capsule is wound around the neck of the bone. The tension of this capsule, 
together with that of the Y-ligament, holds the head of the bone firmly in the socket and 
produces great pressure upon the joint when the limb is in the straight position. (See 

Fig. 6. Straight position.) 

The great abductor group of muscles 
pass diagonally downward from the pelvis 
and are inserted into the shaft at the femur 
posteriorly along the lineaaspera. (See Fig. 7.) 
The flexor group arises from within the 
pelvis, passes downward over the pubes, 
taking a reinforcement which arises from the 
anterior surface of the capsule of the joint, 
and is inserted into the lesser trochanter. 
This group acts over the pubes as a cord 
over a pully, and its power increases as the 
leg flexes. This flexor group is antagonized 
by the inferior portion of the glutseus 
maximus. 

The external rotators are antagonized 
by the tensor vaginae femoris and a por ion 
of the glutaeus minimus and medius. Thus 
we have the several groups in their respective 
order when the limb is in the straight 
position, viz.: 

Glutei group, abductors, antagonizing 
adductor group. 

Flexor group, antagonizing extensor 
group. 

External rotator group, antagonizing 
internal rotator group. 

To determine the relative strength of 
each group the muscles were weighed separ- 
ately, and the triangle in which they operated 
measured, as also was the length of lever 
upon which they operated. The glutaeus 
maximus muscle, w T hich weighed two and one- 
half pounds, acting in a triangle formed by 
a line drawn from its insertion near the great 
trochanter to the centre of the head of the 
bone, three inches; from the head of the 
bone to the origin of the muscles, six inches; 
from its origin to its insertion, six inches, 
was assumed to be capable of lifting fifty 
pounds one inch. This was taken as the 
unit of strength. Other triangular muscles 
of different weights, operating in dissimilar 
triangles, could be accurately estimated as to 
their comparative strength. The rule which I followed was that laid down by Haugh- 
ton (see "Haughton's Principles of Animal Mechanics," p. 183), from which I quote: 

"The work done by the same (a triangular) muscle will be proportional to double 
the perpendicular, let fall upon the side of a triangle from the foot of the bisector of the 
vertical angle." The quality of the muscular fibres of each group very closely cor- 





i34 



respond. In each group are found fine or coarse muscular fibre in about the same pro- 
portion. The rule applied to ascertain the relative strength of the great adductor and 
abductor group gives to the adductor group a decided advantage, because they stand 
paralel with the plane of the triangle, whereas the glutei muscles do not, but were so 

measured and estimated. In spite 
of this advantage given in the 
estimates the abductor group acting 
on the shorter lever was found to 
be much stronger than the adduc- 
tors, the proportion being one 
hundred and thirty-one pounds to 
the abductors, to one hundred and 
\ sixteen pounds to the adductors in 

the subject examined. Then, when 
all the muscles are affected by- 
spasm equally and the limbs parallel , 
the abductors would produce ab- 
duction because of their superior 
strength. 

From our clinical observations 
I at once concluded that the reason 
why the limb went over to the de- 
formity of the third stage of the hip- 
joint disease was because the action 
of these muscles were all changed 
by the flexion of the limb, or from 
pathological destruction of the joint 
changing or annulling the action 
of the muscles by destroying the 
leverage, or localized irritation of 
nerve-plates in the area of disease, 
producing spasms of groups cf mus- 
cles receiving nerve-supply from the 
same common tract. 

The question of nerve destruc- 
tion within the joints quite surely 
plays an important part in determin- 
ing deformities occurring in circum- 
scribed foci of disease. But after 
the entire joint becomes involved, 
the element must be left cut of the 
l question only so far as general 

I spasm is produced in all muscles 

about the joint. I quote from a 
letter of Dr. Towle, Professor of 
Anatomy in the University of Vir- 
ginia, which seems to demonstrate 
that the nerve-supply comes from 
different trunks. 
L ^f • "As to nenous supply of hip, 

what I have seen is as follows: The 
obturator immediately on emerging 
through the obturator foramen gives off a branch which pierces the capsule ; the sacral plexus 
or the upper part of great sciatic, gives off two small branches which enter the back of 
the capsule, the nerve to obturator interims, from sacral plexus, leaving through great 




Pis-. 



i35 



sacro-sciatic foramen, gives a branch to back of capsule. What particular struc- 
ture of joint is supplied by each I cannot say, as I have only traced it to capsular 
ligament. 

When the limb becomes flexed, the abductors begin immediately to lose their power 
as abductors, and in proportion to flexion become inward rotators. 

Figs. S and 9, taken from the dissections, represent the gluteus medius, with the 

limb in a straight position, 
and then flexed to thirty- 
five degrees. In Figure 
8 the muscle acts as an 
abductor, while in Figure 
q its action is changed 
to that of , an internal 
rotator when the limb 
is flexed to thirty -Jive 
degrees. 

Figs. 10 and 11 are 
from photographs of our 
dissections of the glutseus 
minimus. In Fig. 10, the 
limb straight, the muscle 
acts as an abductor; where- 
as the limb being flexed 
only fifteen degrees, it 
becomes a powerful internal 
rotator and increases in 
power as the limb flexes, 
as does the tensor vagina? 
femoris (see Fig. 11): the 
outward rotators become 
abductors when the limb is 
flexed to an angle of about 
forty degrees, with the ex- 
ception of the quadratus 
femoris and obturator ex- 
ternus. The change of 
action in the other muscles 
is quite as marked as in 
these which have been 
illustrated and presented as 
examples. (See Figs. 10 
and 11.) This brings us 
to a consideration of the 
problem before us. 

Question 1. Why in 
the first stage is the limb 
slightly abducted, out- 
wardly rotated, and flexed 
with apparent lengthening? 
part of the patient to relieve 




Fig. is 



Answer. Because of a voluntary effort on th< 
tensions of the capsule and V-ligament. (See Fig. 6.) 

Question 2. Why does this deformity increase, constituting the second stage of 
the disease ? 

Answer. Spasm of the muscles about the hip-joint is present. The great glutei, 
outward rotators, tensor vagina: femoris, and flexors acting together have the advantage 



136 

of leverage and strength (being irritated and affected by spasm, and aided by a voluntary 
effort, or non-resisting effort of the patient, the same as in the first stage) the limb still 
exaggerates the deformity of the first stage. 

Question 3. Asa rule, with an occasional exception, why do limbs assume the 
deformity of the third stage only after flexion to twenty-five degrees has taken place ? 

Answer. Becatise after the limb passed to twenty- five degrees of flexion, the 
abductors to a very great extent become internal rotators (see Figs. 8, 9, 10, 11); the 
external rotators almost totally lose their power as external rotators (see Fig. 11), and 
beco77ie abductors, with the exception of the quadratus femoris and obturator externus, 
and the tensor vaginae femoris becomes a powerful inward rotator. Resistance or an- 







Fig. 13. 



Fig. 14. 



tagonism to the powerful abductors and flexors of the thigh being modified or annulled 
by flexion, the limb must pass to the deformity of the third stage, namely, abduction, 
flexion, and inward rotation. 

Qzie'stion 4. Why do some cases in the third stage of the disease continue the 
deformity of the second ? 

Answer. These may be, and usually are, cases characterized by great abduction 
and outward rotation from the commencement of the disease, or soon after. Many of 
these erratic deformities occur in bed cases from positions of case assumed while lying. 
In others the head of the bone is thrust forward against the anterior and upper border 
of the acetabulum, cutting it away producing a partial dislocation forward. This 
extreme abduction puts the abductors on the stretch and partially paralyzes them by 



i37 



tension. The abductors and outward rotators become permanently contractured , 
adhesions form, and the limb is held in this extreme position of deformity of the second 
stage in the third. 

I have excised two cases of this deformity, and in both cases the head of the bone 
had peforated the acetabulum anteriorly and superiorly, and the bone was held firmly 
against the pelvis by bands of adhesions. 





Fig. 12 is taken from a photograph of a case where the head of the bone had cut 
away the acetabulum anteriorly and superiorly, and was about to escape through the 
openings forming in the acetabulum into the pelvic cavity. 

Dislocations may take place anteriorly and posteriorly; posteriorly, often from large 
•effusions or other pathological cause ; but anteriorly from destruction of the anterior border 
of the acetabulum, due to the action of the external rotators and glutei muscles and 



i38 

destruction of bone from disease. The shortening of the neck of the femur destroys the 
action of the flexors and the abductors by changing the leverage. 

Question j\ Why did one of the cases have abduction, outward rotation, and 
shortening without flexion? (See Fig. 4.) 

Answer. Because of the destruction of the head and neck of the femur, or the 
passing of the head through the acetabulum anteriorly. This destroyed the leverage of 
the glutei and flexors, which gave the abductor full power to abduct while the external 
rotators still acted. The same cause explains the deformity in Fig. 5, only the head took 
a backward course owing to destrticlion of bone in that part of the acetabulum. 

Nerve distribution within the joint undoubtedly plays an important part in producing 
special actions of groups of muscles, depending on the location of the lesion. As for 





Fig. 17. — The Cheap 
Dispensary Splint. 



Fig. 18.— The Double 
Dispensary Splint. 



example, in the knee-joint ilexion is never seen in disease of the patella alone. This is- 
due to the fact that this portion of the hip-joint is supplied from the anterior crural and ob- 
durator nerves, which trunks supply the extensors of the limb, and not the flexors. 
Whereas flexion occurs in disease of the condyles, the nerve supply of which is derived 
from the great sciatic, which nerve-trunk supplies the chief flexors and not the extensors 
of the limb. 

To furthur illustrate the action of the muscles about the hip-joint, the limb being. 



139 

straight and then flexed, I present this manikin, with rubber straps so placed as to repre- 
sent the action of the various groups of muscles. Fig. 13 should represent the limb 
parallel, but the artist failed to place them so. Abduct the limb, as seen in Fig. 14, and 
the pelvis tilts and the right limb appears too long,. This relieves the pressure within 
the joint by unwinding the capsule (see Fig. 6), and puts the abductors on the stretch, 
enfeebling their action until flexion 'commences or the head and neck are destroyed by 
disease. The abductor group being stronger, holds the limb in position, (See Fig. 15, 





-The Patent Splint Adjustive 
High Shoe, and Crutch. 



Fig. 20. 



Inside Bar and Lateral 
Traction-lever. 



side view, limbs parallel.) Then as flexion commences the action of every muscle is- 
changed or modified (see Fig, 16), and the limb must assume the position of the third 
stage of hip-joint disease, viz., flexion, abduction, inward rotation. 

Conclusions. — Normal or typical deformities are produced by change of leverage 
and action of muscles due to — 1. A voluntary effort. 2. Involuntary spasm or con- 
traction of muscles. 3. Nervous irritation of groups of muscles due to location of 
lesion in or about the joint. 

The erratic deformities are produced by change of leverage, due — 1. To patho- 



140 

logical causes, e. g., destruction of bone, head, neck, or acetabulum. 2. Nervous irri- 
tation of groups of muscles, due to location of disease in and about the joint. 

The pathological causes of erratic deformities are — 1. Shortening of the head and 
neck of the femur. 2. Perforation of the acetabulum. 3. Shortening of the limb from 
either of the last named causes. 4. Burrowing of pus through groups of muscles, 
either irritating them to contraction or destroying them. 5. Dislocations from destruc- 
tion of bone. 6. Dislocations from large effusions. 7. Cicatricial contraction binding 
down and restricting the limit of motion of the femur. 

The explanation of the cause of the deformities existing in hip-joint disease is applia- 
ble to every joint in the body, and very soon I will publish the result of experiments on 
all the other joints. 

I have for the sake of brevity omitted the mathematical work, and aiso the results of 
the study of the action of flexor and extensor groups, for to my mind they play altogether 
a secondary part in the drama. . 

The reader at once asks the question, "Why all this work? what good can come 
of it?" I will briefly answer: In the treatment of hip-joint disease fixation to prevent 
motion, and extension, to overcome intra-articular pressure, is the law of treatment. 

We have observed that these great and powerful groups of muscles act upon the 
thigh with so much force as to produce great deformities. That the patient voluntarily 
assume certain positions to relieve the tension of the capsular ligament whether there is 
effusion or not. That these groups of muscles do not act on an axis with the shaft, but 
nearly on a line parallel with the axis of the neck of the femur. From these facts we 
must decide that to relieve intra-articular pressure by overcoming the contraction of the 
muscles traction should be made in the line of the axis of the neck and not of the shaft. 

Patients with deformity should be put to bed with two lines of extension one in a 
line with the axis of the shaft and deformity, and the other at right angles to the shaft. 
If abscesses are present they are always incised and washed out with bichloride of 
mercury, solution 1 to 1000, then thoroughly disinfected with Marchand's Peroxide of 
Hydrogen (H 2 O2 medicinal), then the joint and abscess cavity filled with iodoform 
and glycerine, one-half to four ounces, and finally packed with gauze, dead bone is 
removed to any extent up to complete excision if necessary. Then when the deformity 
is overcome I place them on a lateral traction fixation splint, which I devised with a high 
shoe on the well limb, and a pair of crutches, and allow them to take plenty of out-door 
-exercise. A glance at the cuts will convey the idea. 

The thoracic portion is necessary to fix the joint. // is argued that the patient can- 
not sit down. This is incorrect. The patient sits on the side of a high chair and the 
leg and splint fall to the side the same as any other hip splint. Sayre says the patient's 
leg must stick out and be in the way. 

So must it when his hip or knee-splint is adjusted. He also, says anchylosis must 
result from this fixation, that motion is necessary to prevent the accident. I have not 
-observed bony anchylosis nor angular deformity in over two hundred cases, many of 
whom have been fixed from one to four years without motion. 

Sayre's knee-splint fixes the knee by extending from below to above the knee without 
a joint. If fixation is good for a diseased knee, why is it not good for a diseased hip ? 
Is there any difference in the treatment of the same disease, whether in the hip or in the 
knee ? Should we have a plan of fixation for the knee and motion for the hip ? 

Shaffer's statistics show anchylosis in about sixty per cent, of his cases reported. He 
.uses the long traction splint, essentially the same splint used by Sayre, Taylor, and others 
— one that permits of free motion at the hip-joint. The patient is allowed to walk upon 
ihe splint, and nearly every case recovers with angular deformity. This is wholly 
.unnecessary. No case need recover with bony anchylosis or angular deformity. 

I do not pretend to have solved all the problems of the causes of the deformities 
•occurring in morbus coxarius; but I offer this paper as a preliminary one to further 
:Study of this most complicated joint in a condition of disease. 

These splints are made by Ford of New York. 



141 

THE ETIOLOGY, DIAGNOSIS AND TREATMENT OF 

ULCERATION OF THE RECTUM. 

By JOSEPH M. MATHEWS, M. D., Louisville, Ky. 

Read before the Mississippi Valley Medical Association, at Indianapolis, Oct. 5, i8gj^ 

(Published by the New England Medical Monthly, January, 1894.) 

The time allowed to reading papers before the society is too limited to permit of an 
exhaustive review of my subject. 

I will therefore only deal with it in a general way. For a matter of convenience I 
will classify these ulcers under four heads, viz.: benign, malignant, tubercular and 
specific. To this division there might be a valid objection based upon correct patho- 
logical grounds. As for instance: In this classification I make the term malignant, 
synonymous with cancer, and yet the tubercular ulcer may in truth be malignant, 
without assuming the characteristics of cancer. Again, some writers would have us 
believe that the tuberculous patient was closely akin at last to the syphilitic one, or 
vice-versa, and thirdly, there is a well grounded belief with pathologists that innocent 
or simple ulceration may at any time take on proportions of malignancy These sub- 
jects would take more time than is given me, to discuss them to-day. Therefore to begin 
in the order named I would say that benign ulceration is not so frequently found 
in the rectum as is supposed. Indeed whenever I meet with a well defined ulceration 
existing in the rectum I immediately begin to suspect some special diathesis. One 
would think that from the office of the rectum it was particularly liable to become ulcerated. 
But if we study the part anatomically it will be seen that nature has provided it well for 
the purpose it serves. For instance its mucous membrane is much thicker than any other 
portion of the intestinal tract, and therefore more able to resist irritation. The pouch of 
the rectum is very capacious and sufficiently able to accommodate the supply. It is only 
when the physiology of defecation is interfered with that any danger is to be feared. The 
lumen of this portion of the gut is not narrowed by any ordinary causes. For these and 
other reasons I have long since been forced to believe that such ascribed causes as preg- 
nancy, dysentery, etc., were not great factors in producing ulceration of the rectum. 

Malignant Ulceration. — The rectum is a favored seat for cancer. Many times the 
disease is overlooked entirely or diagnosticated as some other affections. It has occurred 
to me several times to have had patients referred to me for some trivial rectal trouble and 
found cancer instead. One would think that of all diseases affecting this portion of the 
body that cancer could be most easily told. If we take the books as guides I can very 
readily see that a faulty diagnosis is quickly arrived at. If we are to believe that such 
symptoms as pain, hemorrhage, and the discharges, are characteristic, and that the odor 
is pathognomonic, then cancer is quickly told. But when it is a fact easily demonstra- 
ted thaj cancer may exist without even one of these symptoms being recognized, it then 
becomes a matter of much confusion. You might ask, have we not in the microscope 
an infallible resource for diagnosis? I would answer, I think not. Upon five different 
occasions has the microscope told me that I was dealing with a carcinoma when the 
after treatment revealed the fact that it was not so. I am inclined to believe that about 
as much as we know on this subject was known many years ago. "The cancer cell is 
widely different from the gland cells, and they are grouped differently from the natural 
cells." What are we to do, then, when dealing with a suspected case of cancer? Take 
the general clinical history, with symptoms, to aid our diagnosis. 

Tuberculous. — This is a more common form of ulceration of the rectum than is 
generally supposed, reversing, in my opinion, the verdict in the case of benign ulceration. 
Koch's discovery of the tubercle bacillus 1 as thrown much light on this subject, and 
aided us materially in the treatment or all forms of tubercular affections. The treatment 
of tuberculous joints, bone, tissues, etc., has nearly been revolutionized by this dis- 



142 

covery, and although it has knocked out of joint that old and most sacred teaching of 
heredity, it has done much for the afflicted. It had become almost a part of theology 
to believe that the sins of the father were visited upon the children for generations, but 
it is unorthodox (medical) for one now to believe that consumption is hereditary. I 
have seen many cases of tubercular ulceration of the rectum that went on to a fatal 
termination, without the slightest sign of tubercle in the lung. The diathesis bears 
such unmistakable symptoms that it is hard to mistake. 

Specific Ulceration. — That syphilis is the cause of ulceration of the rectum no one 
will deny. That it is responsible for fully one-half of the cases, I am fully convinced. 
Although I have been criticised for saying this, I am more convinced every day that it is 
true. I have taken occasion before to say that whenever I see a well-pronounced case of 
ulceration of the rectum, and can clearly eliminate cancer, then in the majority of cases 
it will prove to be syphilitic. 

It is estimated by a late writer that fully six million people in the United States have 
syphilis. Admitting that it often shows itself in the form ulceration in the rectum, it 
is no wonder that the estimate in numbers could occur. One does not have to be in 
rectal practice long until he is surprised at the number of such cases met with. 

Having just incidentally referred to the four causes of ulceration of the rectum 
without going fully into the aetiology, you will permit me to refer in few words to the 

DIAGNOSIS. 

I know of no class of disease that requires more absolutely a correct diagnosis than 
do these. The treatment must in every individual case depend upon a correct opinion of 
it. We cannot treat a benign ulcer as we would a malignant one; nor a tubercular ulcer 
as a specific one; nor the last named as the first named. 

Benign ulceration must begin as a lesion to the mucous membrane. The term 
trauma here would be most appropriate. Therefore, a history of a wound, or anything 
that might lacerate, break, or in any way damage the membrane, must be scught after. 
Of course the class of ulcers called irritable cannot be considered in this article. They 
have one symptom that will always diagnose them, viz., pain coming on directly after 
stool, and a search reveals the ulcer on, or embracing the sphincter. The appearance 
of a benign ulcer is very different from any other character of ulceration. Its edges are 
hard and resist invasion. The base and margins are likewise, and a quick disposition to 
heal exists with the slightest treatment. In other words, an innocent ulceration in the 
rectum is very much like the same located anywhere else. A malignant ulceration 
possesses properties directly opposite to the benign type of ulcers. Their disposition is 
to infiltrate, and break down. No treatment will prevent this. The edges and base 
quickly yield and the ulceration rapidly extends. I would much rather trust to these 
conditions to tell me the nature of the ulceration than the so-called pathognomonic signs 
of bleeding, pain and odor. The tubercular ulcer is closely allied to the malignant one 
in general appearance and some characteristics. It bleeds freely when touched, is dis- 
posed to break down and sometimes its progress is rapid. One characteristic, how- 
ever, is that the process is painless. I have seen cases of this kind where the buttock 
was nearly destroyed, involving the rectum, and the patient complained of but little 
pain. There are two things, however, thai will quickly aid in the diagnosis: 
• I. The diathesis, which is easily discerned. 

2. The discovery of the special bacillus. 

In malignancy the peculiar color or cachexia is secondary to the existence of the 
primary cause, the tumor. In tubercle, ulceration is secondary to the diathesis. The 
physical signs of cancers are nodules, those of tubercle, a ragged and irregular edge. 

Cancer begins subcutaneously as a growth and ulcerates afterward. 

Tubercle begins either as an ulceration or cold abscess. 

The discharge from a malignant ulcer is pus, or pus mixed with blood; from a 
tuberculous ulcer, broken-down tissue serum, and an occasional pus-producing microbe. 

Outside of all physical signs, the microscope would make the diagnosis in tuber- 
cular ulceration. 



143 

In the specific, or syphilitic ulcer, we generally have the history of the disease from 
the patient or prima facie evidence of its existence in symptoms. Besides this the 
feeling given to the finger is unlike any other character of ulceration — not nodular, as 
cancer — nor ragged, as tubercular. Nor does it possess that distinct appearance of the 
benign ulcer. It is not circumscribed by a wall of lymph either, for it comes from the 
ulcerating process of a gummatous deposit, and may extend for inches up the rectum. 
It is more insidious than cancer, and yet attended by all its horrors; in other words, 
just as incurable after it gets a good foothold in the rectum. It is slower in its pro- 
gress than cancer, but cruel in the length of time it takes to destroy. The most terrible 
cases of it that I have ever seen have been in pure, virtuous women, the victims of the 
husband's vices. 

Treatment. — I can barely allude to treatment of these different ulcerations and will 
make it suffice to call attention to the methods briefly: 

Benign. — Local application. 

Malignant. — Extirpation. 

Tuberculous'. — The curette. 

Syphilitic. — Anti-syphilitic treatment. Colotomy, local medication, extirpation. 

In the treatment of the first-named, benign ulcerations, it is absolutely necessary to 
have rest for the part. Mr. Hilton gives us a most excellent hint in this regard in his 
little book called Rest and Pain. Every surgeon has recognized how utterly fruitless 
have been his efforts to heal ulcers on the lower extremities while his patient persisted 
in walking about. So with the rectum, if it is to be used every day in evacuating the 
bowels, that disturbance will prevent the healing process. The first thing to be done is 
to thoroughly purge the intestinal tract; second, confine the patient to bed; third, local 
applications. Having the bowels purged, a large enema of hot water should be given, 
the patient put upon a liquid diet and if the ulcer is in the veins and is at all indolent, 
it should be touched with nitrate of silver or other stimulating applications; after healthy 
action is established an injection made into the rectum daily of: 
B, Sweet almond oil § j. 
Iodoform, gr. v. 
Sweet nit. bismuth, 5 ss. 
will do much to cure the ulceration. Every fourth day the patient should be given an 
aperient. I need not call your attention to the fact that these patients are often treated 
per mouth for dysentery, which they have not, when a few days of local treatment will 
effect a cure. 

Malignant I 'Iceration. — In the introduction of treatment I have said that ulcers of 
a malignant type should be extirpated. I know how common the idea and practise is 
to resort to colotomy for this condition. By comparison it is in substance this. By a 
colotomy you do a disgusting operation, and leave the offending mass just where it was; 
by extirpation you remove or attempt to remove that which is sure to kill if left. By 
Kraske's operation we are enabled to accomplish that in many cases. 

Tuberculoits Ulceration. — According to modern thought and investigation we 
must believe that from any given point of a tuberculous deposit, infection of neighbor- 
ing or distant parts may take place. The conclusion then is irresistible that said point 
must be destroyed. 

It is clearly demonstrated that if that point be in the rectum the curette is the best 
instrument or way to get rid of it. In so doing, however, the same hint that is to be 
observed in removing cancer must be observed here, it must be done thoroughly. 

Syphilitic Ulceration. — The ratio of difference between cancer and syphilis of the 
rectum is in the time that each takes to kill, and the advantage that accrues to the pa- 
tient will be given to cancer, for it ends the misery much quicker than its competitor, 
syphilis, which inflicts a long drawn out misery with a certain death. I have often said, 
and still insist, that where a syphilitic ulceration with coincident stricture of the rectum 
exists, the condition is just as incurable as cancer. 

If then the ulceration is seen in its incipiency, which it really is, we must rely upon 



144 

anti-syphilitic and local treatment; if a stricture exists and is within reach it should be 
resected; if located beyond the reach of the finger and is a close constriction, an inguinal 
colotomy is advisable. In all these operations around the rectum I am in the habit of 
using as a cleansing agent, Marchand's Peroxide of Hydrogen. Indeed I consider the 
preparation indispensable in my work. Whatever strict asepsis will do in wounds else- 
where it is best in wounds around the rectum to use chemical agents, and the best of 
these is Peroxide of Hydrogen. Not having time to elaborate the points hinted at in 
this paper, I will close by saying that if any additional light has been thrown upon this 
very important subject by this paper, I am repaid. 



DIPHTHERIA— FALSE MEMBRANE EXPELLED— 
RECOVERY. 

By PERCIVAL LANTZ, M. D., Alaska, W. Va. 

(Published by the Medical Brief, St. Louis, Mo., January, 1894.) 

During my absence at the World's Fair and St. Louis (where I had the pleasure of 
meeting the genial and scholarly editor of the Brief,) Roy W., aged five years, was 
taken ill of diphtheria. Dr. Hodgson, of Cumberland, who had charge of my practice, 
was called and treated the case secundum art em, and the patient seemed to be getting 
along very nicely until on Monday, September 18, when he was discharged by Dr. H. 

I arrived home on Monday and on the following day was called to see the patient. 
I found him very much prostrated, breathing sonorously and with great difficulty; 
croupous cough, unable to speak above a husky whisper, diminished respiratory mur- 
mur, and moist bronchial rales. The last two symptoms being ascertained upon aus- 
cultation and implicating an invasion, by the false membrane, not only of the larynx 
and trachea, but also of the bronchi and bronchial tubes. This condition of affairs had 
existed, I was informed, since the evening before, but the family, not knowing that I 
had returned, did not send for me. When I arrived at the house, I realized the fact 
that the case was a critical one, as the larynx, trachea, bronchi and bronchial tubes had 
been invaded by the false membrane. 

As the little fellow had so much difficulty in breathing, his parents were very 
anxious that I should "give him something to make him breathe better," so I concluded 
to give him carbonate of ammonia in order to thin and render less tenacious the profuse 
bronchial secretion, and thus allow it to be more readily expectorated. I did not have 
any of the carbonate with me, however, so I placed him on the following: 
1$ Ammonii chloridi, gr. xl. 
Spts. ammon. aromat., 3 ij. 
Aquae, q. s, ad § ij. 

I also ordered inhalations of the steam from hot vinegar, and had the iron and 
potash mixture, left by Dr. H., continued. 

On the following (Wednesday) morning, I called again and found the patient in the 
same condition, but much weaker. Parents and friends had given up all hopes of his 
recovery, but I ordered the medicine and inhalations continued, telling them that it 
couldn't do him any harm and there was a possibility of the false membrane being ex- 
pelled if it should become sufficiently loosened by the steam and medicine. I did, by 
the way, suggest intubation or tracheotomy as a last resort, but the parents were inclined 
to think, from what Dr. H. had told them, that it could only prolo«g life for three or 
four days, and so did not consider it worth while to try it, as they felt that the child 
could not live long under any circumstances. 

I was called again on the afternoon of the same day, but before I reached the house 
(it being five miles from town), the patient had, during a violent attack of coughing, 



i45 

expelled the false membrane, and though completely exhausted, was breathing very 
naturally. The membrane, which I still have preserved, is a perfect cast of the larynx, 
trachea, bronchi, and on one side, of three bronchial tubes. My professional brethren 
who have seen it say they have never seen or heard of so extensive a cast of membrane 
being expelled. The patient was very weak for awhile, and was given two teaspoonfuls 
of whiskey every half hour for thirty-six hours, then the same amount of whiskey every 
two hours, and in addition 1. 130 grain of strychnia sulph., every three hours, continuing 
the ammonia mixture and a spray in nose and throat of Marchand's Peroxide of Hy- 
drogen. The patient made a good recovery. For a few weeks his voice was consider- 
ably impaired, but it is now about the natural tone. 

I might state that my treatment of diphtheria varies somewhat according to cir- 
cumstances. As a rule, however, I give a mixture of tincture ferri chloridi, potassii 
chloratis, glycerini and aquas every hour. Also a spray of listerine or Peroxide of Ply- 
drogen, and stimulate the patient. I always give a sufficient quantity of hydrarg. chlor. 
mite in the beginning of the attack, or when I first see the patient, to move the bowels 
and often continue it in small doses, say one-tenth grain, throughout the course of the 
disease. I consider it a good plan to keep turpentine boiling on the stove or over a 
lamp in the sick-room, and I always have this part of the treatment carried out. The 
turpentine, either the spirits or oil, should be renewed as often as necessary to render 
the odor distinctly noticeable by the attendants. Have also found the vapor from 
slackened lime or hot vinegar very useful, especially in cases of diphtheritic laryngitis. 



FRACTURE OF THE SEPTUM NARIUM— IRRITATIVE 
CONGESTION OF THE TURBINATES. 

By CLARENCE C. RICE, M. D. 

Professor of Diseases of the Nose and Throat at the JV. Y. Post- Graduate Medical 

School and Hospital. 

(Reprinted from The International Journal of Surgery, March, 1894.) 

Gentlemen: 

As this is the first time that this patient has presented himself at the clinic, I will 
give you a brief history of his symptoms. He is a fireman, age 34, and seven years ago 
sustained a fracture of the nasal septum. He coughs a great deal on getting out of bed 
in the morning, and complains of a considerable amount of mucus dropping down from 
the nose into his throat. 

This symptom of mucus dropping down the throat, I wish, incidently, to remark, 
does not necessarily result from a hyper-secretion, but rather is due to an occlusion of 
the nares, in consequence of which the normal secretion collects in the back of the nasal 
cavity and is carried into the pharynx by the force of gravitation. This is an im- 
portant point for you to remember, for in the treatment of this condition we are not 
called upon so much to use astringents, as to open the nostrils, so. that the air can enter 
and carry off the nasal secretions. If this were a condition of mucous membrane secret- 
ing more mucus than it should, then the use of astringents would be indicated. We 
know from long experience that by opening the nostrils, so that a good current of air 
will pass through them, this symptom of dropping of mucus into the pharynx is decreased. 
I wish to say that almost all anterior nasal obstructions are due to trouble upon the 
septum rather than with the turbinated tissues, and this is very important for you to re- 
member. I have seen cases where the whole mucous covering of the anterior turbinate 
had been destroyed by some caustic so that the functionating part of the nose had been 
irretrievably damaged, while the real cause of obstruction, a bony projection of the sep- 



T46 

turn, had been left untouched. I saw a case of a young woman a few days ago where 
the whole turbinated covering had been destroyed by chromic acid. You might call 
such a condition as this a traumatic atrophic rhinitis, because the mucous membrane is 
dry, and the secretions dry into scabs. The pharynx also becomes dry, and there is a 
condition known as pharyngitis sicca. 

Now, so far as this man's external deformity is concerned, we notice a dropping of 
the nose at its end and a prominence on the right side at the junction of the cartilagin- 
ous with the bony septum, as a result of the blow he received seven years ago. 
The cartilaginous septum should join the bony septum, as you know, in a straight line, 
but in this case they are placed at an angle to each other. 

On examining this man's nostrils we find a few points of interest. In the first place 
the anterior end of the cartilage is turned to the right, and we see what is called a chon- 
drosis on the left side of the septum — that is a proliferation of the cartilage at that point. 
Now, what is to be done for this condition? If he obtains a sufficient supply of air 
through the right nostril — and he seems to — I should not do anything here because the 
projection of the anterior end of cartilage acts as a protection against the dust. If it 
were necessary to give him a little more breathing space I should with scissors cut off 
a piece of this tissue, but I should certainly not adopt this procedure till I had given him a 
proper amount of breathing space in the other nostril. The important nostril is the other 
one, and here you see there is a deflection of the septum on itself. Now this convexity 
corresponds to the concavity just behind this prominence on the other side, and has re- 
sulted from the traumatism. 

What is the operation necessary in this case? There will be no difficulty in remov- 
ing, with a straight saw, what is necessary from this cartilaginous prominence. We 
avoid the danger of perforation by not cutting too deeply, but there are cases where the 
tissues are so thin that it is impossible to prevent this occurrence. The disagreeable 
features of perforation are that if the opening is situated anteriority, you are apt to get 
a sinking of the nose from lack of support and a tendency to ulceration. We will here, 
as a preliminary measure to the operation, insert a piece of cotton saturated with an eight 
per cent, solution of cocaine, and permit it to remain five or six minutes, then we will 
take a swab, dip into a solution of Peroxide of Hydrogen (Marchand's) and cleanse the 
nostrils thoroughly. We will not proceed further with the case till we have cocainized 
the interior of the nostril. 

We will now look at his pharynx, and there you see a condition that can be styled 
a catarrhal pharyngitis, with lymphatic thickenings on the posterior wall. I always like 
to have the gentlemen look at the pharynx the moment the patient opens his mouth. It 
was a very red pharynx when we looked at it first, but now, as a result of three or four 
inspirations through the mouth and evaporation from the mucous membrane, the color- 
has disappeared. Now you notice little points on the posterior wall of the pharynx. 
That is the same condition you see in children who have enlarged adenoid tissue in the 
vault of the pharynx. 

We see here, a localized congestion of the posterior nasal space, or posterior nasopharyn- 
gitis, and our aim is to remove this congestion . We do that in a case like this by curetting the 
vault of the pharynx, or applying a sixty grain solution of silver to -the ounce to the part. 

Now to return to this man's nasal trouble, we will remove the cocainized piece of 
cotton from the septum and excise a portion of this thickened tissue that I call your at- 
tention to. As this is a cartilaginous deflexion, it is proper to use a saw or a trephine 
for its removal. You are able to apply the saw better by having an assistant hold the 
patient's head at such an angle as to make the enlargement of the septum stand out 
prominently until the operation is completed. Having removed this portion of tissue 
we will take powdered boracic acid and blow it into the nostrils, and in ten or fifteen 
minutes repeat this procedure. The only cleansing we advise here is to have the patient 
blow his nose thoroughly with a handkerchief, and we use no wash until the third day 
for fear of washing away the clot that forms. On the third we generally use a posterior 
nasal syringe with a 25 per cent, solution of Peroxide of Hydrogen. 



147 

The next patient is a young man twenty years of age. As we look at his nostrils we 
observe a slight projection on the left of the septum. This may be a passive or hypos- 
tatic congestion and due to a posterior turbinated swelling. Now, to improve the con- 
dition in this nostril we will use the galvano-cautery, applying it to one little point, for 
we do not believe in creating a burning wound covering a great extent of surface. We 
simply make a small line with a cautery which will be sufficient to contract the general 
soft swelling. 

There was a time when I would have called this a hypertrophy of the inferior tur- 
binate, and perhaps would have applied the galvano-cautery, chromic acid or some other 
destructive agent. If you take a probe and press on the swelling of the inferior turbin- 
ated, you will find that you can push the tumor back. There is no real enlargement of 
the inferior turbinated, but a reflex swelling due to obstruction elsewhere. 

How are we to treat such a condition as this? We should not apply any destructive 
agent to this part because we want it to remain intact. We might term this trouble re- 
flex or irritative congestion due to the pressure of the septal spur against it. Rather 
than destroy the mucous membrane which is useful in the man's nose, we might as a 
compromise measure take a galvanic cautery point and insert it in the inferior turbinated 
down near the floor. In that way you get a reaction of this tissue without destruction 
of its mucous surface. 

Now, while this right nostril is a fairly roomy one, it is not quite as large as the 
left, and as you look well in you see that the middle turbinated bone is in contact 
with the septum. If a little of that middle turbinated was taken off, the anterior 
part of the nose would be the better for it, and for that reason we will pass in between 
the middle turbinated and the septum a pair of scissors and remove a small amount of 
the tissue. Now as I do this you notice the retraction of the anterior swelling. 



TREATMENT OF ACUTE AND CHRONIC ULCERS. 

By JAMES OSBOURN DeCOURCV, M. D., St. Libory, III. 

(Published by Louisville Medical Journal, August, 1894.) 

I have found no class of diseases yielding to treatment with greater reluctance than 
"old sores," or chronic ulcers. Recently, however, I have adopted a plan of treatment 
which is quite different from that laid down in the books, and my results have been 
much better. 

Almost without exception, internal, or constitutional, as well as local treatment, is 
necessary. 

The internal treatment should be directed to the seat of the malady, thus eradicating 
the general pathological condition, eliminating the poisons and disease germs from the 
system. 

To accomplish this object, absolute cleanliness (internal and external), plenty of 
pure air and sunshine, the religious observance of the laws of hygiene, and a wholesome 
nutritious diet, are more useful and restorative in their effects than are drugs. All the 
secretory organs of the body should be required to perform, as nearly as possible, their 
natural amount of work. 

This once accomplished, and all nature's machinery kept lubricated and in good 
working order, the local treatment and work of reconstruction will be comparatively easy. 

The sores, ulcers, acute and chronic, must be kept clean. This is. done very satis- 
factorily by the application of hot water. If the parts can not be soaked in the hot 
water, an ordinary fountain syringe can be filled with water (as hot as can be borne, 
without burning), elevated high enough to give sufficient velocity to the stream which is 
played over the parts, by the operator holding the nozzle of the syringe a short distance 
from the seat of the application. The frequency of the washing will depend upon the 
nature of the case, but should be repeated as often as necessary to keep it clean and 
free from offensive odors. 



To destroy pus and bacteria, and to ai 1 nature in the work of rebuilding the parts 
invaded, I have found Hydrozone and Glycozone superior to any and all other agents 
tried. 

Hydrozone is first applied (after the hot water) by the use of an ordinary glass 
dropper, or hard rubber syringe, slowly, all over the ulcer, until the pus is destroyed. 
Effervescence, or fermentation, continues until the enemy is quite dead, but no longer. 
One layer of absorbent cotton is saturated with Glycozone and placed smoothly over the 
parts, and held in place by a cotton bandage, sufficiently tight to hold the cotton in place. 

Other local medication might do as well in some cases, but I have not so found it. 
The result obtained in the case I report herewith seems to confirm the statement as 
above made. 

Edw. K., age twenty-three. American, but German descent. A farmer by 
occupation; unmarried. Rather small in stature, but well-built. Having taken sixteen 
bottles of "Blood purifier" and a lot of "Anti-constipation pills" within the last eight 
months for "Falling sickness," came to my office March 19th, with both legs most 
frightfully ulcerated, from knees to ankles, with considerable discharge of pus frorr 
various parts of the legs. Such a case should have been sent to a hospital or sanitarium, 
for the best systematic treatment obtainable, but, unfortunately, he was so situated that 
he could not be sent to such a place. In a most pleading way, he asked me if I could 
do him any good. I told him I thought so, if he would mind me, and take the treat- 
ment that I should advise. He promised, and the treatment was begun. 

The legs were cleansed by soaking them for twenty minutes in hot water twice a 
day, after which Hydrozone was used freely all over the sores, to destroy the pus, the 
pustules having been opened, and as much pus evacuated as possible. 

After this application, morning and evening, the legs were powdered all over the 
affected portion with a mixture of equal parts of alum, boric acid and aristol, then 
covered with absorbent cotton, and bound up with an ordinary cotton gauze bandage. 

This local treatment was kept up for two weeks. The improvement was slow, but 
constant. The process of healing advanced from the knees downward, and from the 
ankle upward, leaving the last part to heal about the middle of the leg, where the ulcer- 
ation formed a thick crust, extending two-thirds around each leg. 

The constant discharge of pus from the sores caused the dressing to stick to the 
parts, which could not be removed without difficulty. 

The alum, boric acid and aristol powder was discontinued, and Glycozone used as 
a reconstructive agent, from the end of the second week. The sores were washed and the 
Hydrozone used as before mentioned, then the Glycozone was applied to the whole 
affected parts. A layer of absorbent cotton was saturated with Glycozone, and smoothly 
placed around the sores, and held in place by a cotton bandage 

There was not any further trouble about the bandage adhering to the sore. The 
granulation was much more rapid than at first. At the end of the second week after 
Hydrozone and Glycozone were used as the sole local agents, the young man said he 
was well, and worked every day from that time. 

The internal treatment was changed from time to time as the case required. 
Opiates were given several times during the first two weeks of the treatment, to ameli- 
orate the pain, which was very great at times. He was much emaciated and melancholy 
when he first came to me. His bowels would not move without cathartics. 

Fluid extract nux vomica was given morning and noon, seven drops before each 
meal. Elixir lactopeptin, with bismuth, was given in drachm doses after each meal, 
and, occasionally, laxatives at night. Later on, tincture chloride of iron was given, in 
ten drop doses, after each meal, for one week. 

After the third week no internal treatment was given, as the patient was in good 
condition, happy and cheerful. 

Hydrozone and Glycozone were left to complete the structure, and place upon it the 
capstone of a beautiful new integument, which they did in a way gratifying both to the 
patient and to myself. 



149 

THE TREATMENT AND CURE OF CHANCRE WITH 
PEROXIDE OF HYDROGEN. 

By WILLARD PARKER WOOSTER, M. D., New York. 

(Reprinted from the Journal of Cutaneous and Genito- Urinary Diseases, for February.) 

The subject of the best treatment of the primary sore of syphilis has occupied the 
minds of investigators of late years' to such an extent that almost every surgeon has a 
different method, and the general practitioner is somewhat at a loss to know which is the 
best treatment to employ as the most expeditious means of relieving the anxiety of the 
patient and curing the lesion. The special purpose of this paper is to draw attention to 
a particular method of treatment, which not only relieves the anxiety of the patient and 
places him in a delightful bouyancy of mind, but cures the chancre in the shortest pos- 
sible time, without pain or detention from business, and with less scar and less destruc- 
tion of tissue than any other method. 

The chancres of the following cases, selected from a good many recorded, were of 
the large Hunterian variety, embracing the worst formi, of sloughing and phagedena. 

Case i. — Mr. K., aged 38 years, came to me, January 29, 1891, with a large 
sloughing single chancre, situated on the right side and at the base of the glans-penis, 
and at the junction of the prepuce and very deep; incubation about thirty days; penis 
large and soft. Sprayed it with full strength solution (15 volumes) of Peroxide of 
Hydrogen medicinal (Marchand's), at 60 pounds pressure, and dressed with iodol 
powder, and continued the same treatment every morning at 7 o'clock. 

February 20, sprayed it as above; sore now only skin deep, and continued till 
February 23, sore healed; duration of treatment, twenty-five days. 

Case 2. — Mr. W. B., came to me, September 6, 1892, with a single sloughing 
chancre on left glans penis, and corresponding ulceration on prepuce; incubation about 
thirty days; sprayed with Peroxide of Hydrogen full strength, 60 pounds pressure, and 
dressed with iodol; continued same treatment every evening at 7:30 o'clock, for sixteen 
days. 

September 23, sore almost healed. 

September 25', sprayed for the last time to-day; duration of treatment, nineteen 
days. 

Case 3. — Mr. L. , aged 28 years, came to me, August 23, 1893, with a phage- 
denic chancre, thirty-five days' incubation, situated immediately at meatus urinarious, 
and sloughing its way very rapidly into the urethra; sprayed it with Peroxide of 
Hydrogen, full strength; 60 pounds pressure, and dressed with iodol powder. Continued 
the same treatment every evening at 7:30 o'clock. 

August 30. Sore almost healed up, only some granulations left. Continued the 
same treatment every evening till September 4. Sprayed it to-day for the last time; 
there only being the surface of the sore about the size of a pin's head. Considered 
himself cured and said he would not come again. Duration of treatment, eleven days. 

The above cases selected from many recorded cases, on account of their possessing 
the worst features of the initial lesion, serve as good examples of the treatment by the 
Peroxide of Hydrogen method. 

I treated Mr. K., of Case 1, on two different occcasions, for the same disease, in 
exactly the same manner, and the two cases are about identical in regard to length 
of time of treatment and as to details, and he got well in about the same manner. 

The case of Mr. L., presented the worst features of phagedena, which was so 
virulent that I think he would have lost the greater part of the glans penis, if he had 
been treated by the nitric acid or caustic method, and as it was, the ulcer healed with a 
very small scar, scarcely noticeable. 

The pressure of the spray (60 pounds), which is one of the most important factors 
in the whole method, not only cleanses and produces thorough asepsis of it, killing the 



i5° 

germs of the disease at the very bottom of the ulcer, but the oxygen of the peroxide 
aerates the blood through the capillaries, and arrest the progress of the disease at the 
nearest possible point, allowing the process of repair to commence as soon as possible, 
according to the severity of the disease, with the least loss and destruction of tissue and 
consequent scar. It must be particularly understood that in using this treatment, all 
instruments, spray-tubes and bottles, must be made of either glass or hard rubber, 
for the reason that metals, with one or two exceptions, coming in contact with the 
peroxide of hydrogen will destroy its component parts and render it useless, and I have 
found also a greater difference in the results if the peroxide is fresh or otherwise. The 
first effect of a spray of peroxide upon the ulcer is to deposit upon it a thick film of albu- 
men; this should be allowed to remain for about half a minute or less; then continue the 
spraying till a large tubeful has been used (one ounce); as the sore progresses the spray- 
ing causes a good flow of rich arterial blood upon it which merely shows returning 
healthy conditions. 

The treatment is entirely painless, and the patients do not experience any annoyance 
or inconvenience whatever while carrying the disease, and freely express themselves 
as well pleased with its effect. 

No internal medication during this stage is given. The iodol powder is used only 
as an antiseptic, to protect the sore from external influences until it is sprayed again the 
next day, keeping the sore in as good a condition as it is left by the spraying, which 
must be done once every day until the ulcer is healed. 

This method of treatment of chancre has been in my hands, the best and most 
successfull of all methods that I have heretofore adopted. 



THE TREATMENT OF TYPHOID FEVER. 
By M. A CLARK, A. M., M. D., Barnesville, Ga. 
(Published by The Food, June, 1894, also the Medical and Surgical Reporter, Phila- 
delphia, Aug. 4, 1894.) 

The first duty of the physician, in the treatment of any disease, is to pay strict 
attention to prophylaxis and hygiene. This is especially applicable to the successful 
management of typhoid fever. 

With proper attention to these, the majority of cases of typhoid fever will recover 
without any medicinal treatment. Hence, we should be very wary in making any 
decided claims for medicines. We do know, however, that there are remedies which • 
will not only mitigate the symptoms but also shorten the disease itself. Such being 
true, it is the duty of every physician to seek diligently for those remedies and to 
judiciously and faithfully apply them. 

In this paper I propose to set before you what seems to me to be the best of these 
remedies. 

Before referring to the subject proper allow me to say that I fully believe that this 
disease is due to some powerful germ, no doubt the bacillus of E berth, which produces 
not only very marked lesions in the parts invaded but also very decided nervous phe- 
nomena and great waste of the whole system. If we, then, can find some remedy that 
will check this dread germ in its ravages and destroy the poison it produces, we have 
found that remedy that will prove a most powerful adjuvant in the management of this 
disease. Our hope, then, lies in the antiseptic treatment. In fact, it seems to me that 
this plan of treatment is par excellence the one from which we may hope to derive any 
decided results. 

Henry claims best results from thymol; Rossbach and Wolff, from naphthalin; 
Pepper, from nitrate of silver; Thistle, from salol; while calomel is urged by others. 
All of these are, no doubt, good and well worthy of trial. Having had such good 
results from the use of another most powerful antiseptic, I beg to offer it as the one for 



i5i 

treatment of this disease, even though it falls short of the definition of an intestinal 
antiseptic as given .by Bouchard: "It should be more or less insoluble and exert no 
toxic action on the organism." This remedy exerts no toxic action upon the system, 
but it is soluble, being in itself a solution. 

I refer to hydrogen peroxide, which all will admit is a most potent antiseptic when 
locally applied. Seeing such excellent results from its local use, I ventured to test it as 
an internal antiseptic, believing that it would prove most effective. Having been 
rewarded with most wonderful results in the few cases in which I have used it, and 
feeling so sure of its continued effectiveness, I offer it to you for your consideration on 
this occasion. 

If given at onset of the disease, it will not only mitigate the severe symptoms but 
will also check the disease itself. The tongue will rapidly clean off; tympanites will 
subside or not appear at all; the diarrhoea will diminish; no marked nervous phenomena 
will ensue; and the disease will spend its force with but comparatively little wear upon 
the system. 

I give from 20 to 40 minims of some reliable 15-volume solution, preferably 
Marchand's, well diluted, every two or three hours until slight nausea is produced, and 
then every four or six hours till convalescence is fully established. 

With its use from the beginning I find no necessity for antipyretics, the tempera- 
ture never rising sufficiently high to authorize their use. If, however, it becomes 
necessary to resort to some means of reducing the temperature, I prefer phenacetine in 
5 grain doses every four or six hours. The Brand method may work well in hospital 
practice, but it cannot be used effectively in ordinary private practice. If the phenace- 
tine is followed by, or given with, a mild stimulant and used only to reduce high tem- 
peratures, there will be no unpleasant effects at all. I cannot say so much for the other 
coal tars, or even quinine. 

I begin at the outset to attend carefully to the diet of my patients, striving to pre- 
vent all the waste possible by giving proper nourishment. Milk is by far the best diet. 
Given in small quantities and at frequent intervals, it is usv.ally well borne. If not well 
tolerated, it may be peptonized and then given without ill effects. Horlick's malted 
milk, beef tea and some reliable beef extract are usually easily assimilated and are valu- 
able aids to the milk. Solid food is rigidly withheld. 

Water should be given, not only in connection with the medicines, but also at 
frequent intervals, whether called for by the Datient or not. It is cooling and refreshing 
to the patient, aids in the elimination of poisons from the system by its diuretic effects 
upon the kidneys, and keeps up the normal amount of body-fluids. It should be deemed 
one of the important factors in the treatment of this disease. 

The mineral acids, inasmuch as they are aids to digestion, should be given iir small 
doses well diluted three or four times daily. I prefer dilute nitro-hydrochloric in ten 
minim doses three times a day. 

Alcohol, should no longer be considered routine treatment but should be used only 
when the symptoms absolutely indicate. Properly treated, few patients will require the 
frequent use of any alcohol. When used, it should be given most cautiously, as too 
much will cause unfavorable symptoms and is worse than not using at all. 

Turpentine stupes, or turpentine locally applied, may be used with benefit, when- 
ever there is tympanites. I find it unnecessary when using Peroxide of Hydrogen. 

If the diarrhoea is excessive, as many as six or eight stools in twenty-four hours, it 
should be controlled by nitrate of silver, bismuth or some other astringent. I prefer 
bismuth subnitrate in 15 to 20-grain doses or salicylate in 5 to 10-grain doses every two 
or four hours. I have no trouble with the diarrhoea, but if it should become trouble- 
some; I would employ in connection with the bismuth occasional enemata of weak 
solutions of hydrogen peroxide, having found them very effective in the summer 
diarrhoeas of children. 

If the Peroxide of Hydrogen is given from the onset of the disease, the so-called 
typhoid phenomena, low muttering delirium, subsultus tendinum, picking at the bed 



clothes and soon, will not occur. If, however, I should be so unfortunate as to have 
to deal with them, I would rely solely on the sedative dose of calomel. It will quiet 
such nervous phenomena when nothing else will, and, too, without any unpleasant 
effects upon the organism. 

Other complications must be treated according to the usual methods. I believe, 
however, they will rarely occur, if this treatment is used from the beginning. 

During convalescence, it is very essential that the patient be rigidly dieted. The 
liquid diet, with a little broth, milk-toast, soft boiled eggs, should be given till the third 
week of convalescence, and even then solid food should be used most cautiously. 

I herewith submit two cases illustrative of the results of this treatment: 

James R., age 10; family history good; previous health good. Had been sick 
with typhoid fever ten or twelve weeks and was in the beginning of the second relapse, 
so-called, when I was called in. Having been poorly nourished, he was anaemic and 
much emaciated. Saw him first in the afternoon. Temperature 106 F., pulse 140, 
weak and irregular, marked tympanites, pain and tenderness in right iliac region, very 
restless, slight delirium at intervals. 

Gave three grains of phenacetine, with four teaspoonfulsof brandy every four hours 
to reduce high temperature. Gave Peroxide of Hydrogen one ounce during the twenty- 
four hours. Milk at frequent intervals. In 36 hours temperature was under control, 
tympanites rapidly disappearing, delirium absent, patient comfortable and begging for 
bread. Continued the Peroxide and nourishment. In one week the temperature was 
normal and convalescence was well begun. Recovery was rapid and complete. 

Annie L., age 9; family history good; previous health good. Had just returned 
from a visit to a place where there was an epidemic of typhoid fever. Had been sick a 
little more than a week when I first saw her. Symptoms showed a case of typhoid 
fever of no mild type. 

Began at once with 20 minims of hydrogen peroxide every three hours. Gave 5 
minims of dilute nitro-hydrochloric acid three times daily. Milk in small quantities and 
frequently repeated. Used phenacetine and salol 1$ grains each to control restlessness 
and produce sleep during the first two days. Afterward, continued the Peroxide and 
nourishment. In less than three weeks temperature was normal and convalescence was 
fully established. Recovery was rapid and complete, there having been comparatively 
little exhaustion of strength and vitality. 



PEROXIDE OF HYDROGEN (MEDICINAL). 
By Dr. G. W. PICKERILL. 

(Reprinted from the Medical Free Press, Indianapolis, Ind., June, 1894.) 

He who does not avail himself of the superior benefit of Peroxide of Hydrogen 
(Marchand) in the treatment of open wounds, ulcers, scrofulous and syphilitic abscess, 
"sores," etc., as a corrector of morbid action and pus destroyer, is denying himself of 
the most powerful agent yet introduced for such purposes. Its beneficial effects are 
seen at once in the destruction of fetid pus and other morbid products when applied to 
an old scrofulous or syphilitic sore. 

Two cases of syphilis with large open sores will illustrate the rapid action of Per- 
oxide of Hydrogen. The first was a most formidable affair of seven years' standing; 
the open sore involving f of the ankle joint — with the joint enlarged to twice its healthy 
size. This sore had been dried, patched and healed over a number of times, but such a 
healing proved of no permanent benefit, for the sore would soon open in a worse state 
than before. There had been no effort to clean the morbid, dead products from the 
base of the ulcer, thus "dried" and "scabbed" over became, as a matter of course, a 
source of irritation and ulceration. Such procedure is very bad surgery for any kind of 
ulcers. 



i53 

A few weeks' treatment with Peroxide of Hydrogen (Medicinal) dressing- with Gly- 
<x>zone, and the ulcer was as clean and healthy looking as need be, and proceeded to 
heal from bottom and edges without further trouble. And remains healed and healthy. 
Will keep patient under appropriate constitutional treatme.it for two years. 

Case second was of more recent date. Knee involved. Although had had consti- 
tutional syphilis, the action in the knee was more the character of tuberculosis of the 
joint. Proceeded to suppuration, opening just below the patella. Treated with Per- 
oxide of Hydrogen and Glycozone locally. 

The recovery was all that could be desired. 

Not so perplexed with these syphilitic and tuberculous ulcers and abscesses since 
Peroxide of Hvdrogfen and Glvcozone were handed to us. 



HYDROZONE. 

By W. C. WILE, A. M., M. D., LL. D., Danbury, Conn. 

(Reprinted from The Prescription, July, 1894.) 

It was that brilliant young surgeon, Dr. Robert T. Morris, of New York City who, 
when he read his paper four years ago, entitled "The Necessary Peroxide of Hydro- 
drogen," touched a key-note which echoed through the world. 

Many indeed knew of its usesand value, of course, before this time, still the masses 
-of the profession were practically ignorant of its wide range of usefulness and the won- 
derful, almost magical power it possessed, let alone the knowledge of the fact that such 
a product existed. 

Morris related his experience which started men thinking and active, while {he re- 
sult was great good to suffering humanity and a rapid stride toward exactness in the 
science of" medicine. 

We feel quite confident that when he turns his attention to the new product of 
Charles Marchand, Hydrozone, that he will be much more enthusiastic about it, as Hy- 
drozone is stronger and superior to Peroxide of Hydrogen. 

Hydrozone is twice as strong as Peroxide and twice as active. 

It works with much greater rapidity, hence more effectively, for in every operation, 
no matter how trivial, it is essential that it be performed as quickly as is consistent with 
good and thorough work in order to lessen shock, and anything that will reduce the 
time to a minimum, will be sure to attract the immediate attention of the conscientious 
and progressive surgeon, and meet a hearty reception. 

The point we mean to lay particular stress upon at this time, is the powerful haemo- 
static action of Hydrozone. In this respect it excels anything else that we know of for 
rapidity of action and effectiveness of work. 

This is particularly true of the venous and capillary oozing. This form of hem- 
orrhage is many times the most troublesome and difficult we have to deal with, especially 
when it occurs in a cavity which it is necessary to dry well before closing and applying 
dressings. 

It is not, however, confined to this class of hemorrhage, as a recent case that came 
under the editor's care will illustrate. A lad nine years old while attempting to chop 
some kindlings, let the axe slip, and the heel of the instrument penetrated the instep of 
the right foot, severing an artery. 

There was no ether at hand and the office a long way off, while every effort made 
to pick up the artery resulted in almost convulsions in the excited and nervous boy. A 
pledget of cotton was saturated with Hydrozone, and well packed into the wound, dress- 
ing the whole with gauze bandages in abundance. The hemorrhage ceased at once, 



i54 

and the dressings were allowed to remain in situ till the following morning when the 
patient was put under an anaesthetic and the wound properly dressed. No ligation was 
necessary and the case made an uninterrupted recovery. 

Dr. Elmer Lee, of Chicago claims also that Hydrozone is better than the peroxide 
for internal administration, he having given both in a large number of cases of typhoid 
fever. 



PEROXIDE OF HYDROGEN IN CONJUNCTIVITIS. 

(Published by Medical Fortnightly, April 2, 1894.) 

Lautenbach, Therapeutic Gazette, advocates the use of Peroxide of Hydrogen in 
conjunctivitis. He has been quite successful in the treatment of this troublesome 
disease by the following method: From 10 to 30 drops of the solution, full strength, is 
instilled at the outer canthus of the eye, and with the fingers a degree of massage is 
applied over the entire surface of both eyelids. A second, third or fourth application 
can be made if necessary. In trachomatous cases the eyelids should be everted and 
rubbed with the rubber end of the eye-dropper. A saturated solution of boric acid is 
then used to irrigate conjunctival cul-de-sac. The inflamed surfaces are thus cleansed 
and ready for whatever application is necessary. The treatment is not intrusted to the 
patient, but is performed by the surgeon himself, once or twice a day, or a few times a 
week, according to indications. Dr. Lautenbach says it is important to have peroxide 
test beyond ten volumes, that it should not lose its oxygen on slight change of temper- 
ature, and, most important of all, that it should not contain any free acid. Undue 
amount of free acid causes pain and untoward effects. On account of the uncertainty 
of preparations fit for use, Marchand's should always be procured. The lids should be 
everted and thorough exposure of conjunctiva had; it is then cleansed by warm solution 
of boric acid. 



HYDROGEN DIOXIDE.— H 2 2 . 

By L. D.KASTENBINE, A. M., M. D. 

Professor Chemistry, Urinology, and Medical Jurisprudence Louisville Medical 
College; Professor Chemistry Louisville College Pharmacy. 

(Published by Louisville Medical Monthly, July 1894.) 

This remarkable liquid which contains the greatest percentage of oxygen of any 
compound known, was for some time, considered as a mere solution of oxygen in 
water, and consequently was called oxygenated water. It was afterward obtained free 
from water and found to be a definite chemical compound of hydrogen and oxygen, and 
differing from water in containing twice as much oxygen. In this state it is a heavy, oily 
liquid, readily decomposing at ordinary temperatures, but if heated, with explosive 
violence, being converted into ordinary water and oxygen gas. When poured into 
water it sinks, being nearly half again as heavy as that liquid, but is miscible in all 
proportions with it. It has a somewhat bitter, astringent taste, and is colorless, trans- 
parent and without odor. It contains 94 per cent, of oxygen gas by weight, and will 
yield 475 times its volume of that gas. It bleaches the skin, hair, ivory and destroys 
organic coloring matter, pus and all organisms with which it comes in contact by liber- 
ating oxygen gas in a nascent or active state. It is resolved in oxygen and water by 
certain metals, such as gold, platinum, silver and mercury in a state of fine subdivision, 
although the metals themselves undergo no change whatever. If the oxides of these- 



*55 

same metals are brought in contact with it, not only does the hydrogen dioxide lose 
oxygen and become vater, but the oxides lose their oxygen and are reduced to the 
metallic state, thereby evolving an additional amount of oxygen. 

Strange as it may appear, with all its energetic oxidizing action, it has no effect on 
phosphorus, a substance which is so readily oxidized by the air. 

The preparations found in commerce are only solutions of this compound in water, 
and sold in different degrees of concentration or strength, rated by the number of vol- 
umes of oxygen gas they can be made to yield. A fifteen volume solution is one that 
will give off fifteen volumes of gas from one volume of the solution. A ten volume so- 
lution will yield ten pints of oxygen gas from one pint of the solution, and so on. 

These solutions, although more stable than mere concentrated preparations, never- 
theless decompose and lose their nascent oxygen on which its powerful antiseptic pow- 
ers depend, and consequently we find the commercial brands varying considerably from 
their reputed strengths. The solution I find containing the greatest percentage of 
available oxygen, is the preparation known as Marchand's, which, when perfectly fresh, 
is about a fifteen volume solution. 

There are quite a number of different methods of preparing aqueous solutions of 
this interesting compound besides the original method of Thenard, the discoverer. 
Usually, however, barium dioxide in the hydrated state and purified from all foreign 
matter, is decomposed by such acids as will make an insoluble compound with it. The 
United States Pharmacopoeia has adopted this compound under the official title of Aqua_ 
Hydrogenii Dioxidi, gives a process of preparing it and describes it as a slightly acid 
aqueous solution of hydrogen dioxide, containing, when freshly made, about 3 per cent, 
by weight of the pure anhydrous dioxide, corresponding to about 10 volumes of available 
oxygen. It is made by the action of phosphoric acid upon barium peroxide. It must 
be borne in mind that it is essential to employ a small amount of free acid to preserve 
these solutious, but if too large a quantity it would be a source of irritation when applied 
to denuded surfaces and inflamed mucous membranes, and consequently, officially, a 
preparation requiring more than 0.5 c. c. of volumetric caustic potash solution to neu- 
tralize .50 c. c. of it, does not come up to the U. S. P. standard. 

Of the various brands of ccmmercial dioxides I have examined, I find Marchand's 
to be the one which yields the largest amount of available oxygen under all conditions 
of exposure, and the one which contains the minimum percentage of free acid. All the 
marketable articles I have seen are free from barium compounds, but the majority do 
not come up to the fifteen volume standard, but are 6, 8, 10 and 12 volume solutions. 

In addition to its medicinal uses, hydrogen dioxide can be employed to detect blood, 
in conduction with freshly prepared tincture of guaiac. Although tincture of guaiac 
turns blue with a variety of substances, blood is not one of them. So in testing for a 
stain — say on clothing — moisten the spot with water, and afterwards apply a piece of 
white filter paper; the slightest straw-colored stain on the paper suffices. Now, add to 
the spot on the paper a few drops of the guaiac tincture — no coloration. Add a few 
drops of the solution of peroxide, when instantly the spot turns of a deep azure blue. 
Of course if the spot turns blue by the guaiac alone, it can not be due to blood, yet it is 
possible blood may be present in some other substance which has that property, and 
hence the employment or peroxide, in that case, would be a source of fallacy. If there 
is no bluing by guaiac and peroxide together, then absolutely no blood is present. 

Hydrogen dioxide can be determined quantitatively by permanganate of potassium 
solution acidified by sulphuric acid, and the quantity of oxygen gas evolved measured in 
an instrument called a nitro-meter, and calculated for.normal pressure and temperature. 
One half the oxgen evolved comes from the dioxide and the other half from the perman- 
ganate solution. 

Another method and the one commonly employed, is to add a volumetric solution 
of permanganate of potassium from a burette to a measured portion of the hydrogen 
dioxide solution, diluted with water and acidulated with sulphuric acid, until the per- 
manganate solution is rendered colorless, and then a few drops more of that re-agent 



i56 

■employed till a permanent faint pink coloration is given to the dioxide solution to indi- 
cate the completion of process. A slight calculation will give the strength of solution. 
There are other methods but the two indicated are the best. 

A solution of Peroxide of Hydrogen is usually tested by pouring a drachm of it in 
a clean test tube, together with an equal quantity of ether, then pouring into the tube a 
few drops of bichromate of potassium solution, and shaking the tube, when the ethereal 
layer will become a beautiful azure blue color, due to the formation of perchromic acid 
which dissolves in the ether. 

To a few drops of nitrate of silver solution, add aqua ammonia enough to pre- 
cipitate the oxide of silver, then add hydrogen peroxide when finely divided metallic 
silver separates. A solution of titanic acid in oil of vitrol and diluted will yield a yellow 
color when added to soultions of the peroxide. 



DISEASES OF THE ALIMENTARY CANAL.— TREATMENT. 

INTERNAL AND EXTERNAL HYDROTHERAPY. MEDICATION. 

By JAMES OSBOURN DeCOURCY, M. A., M. I)., St. Libory, III. 
(Read before the St. Clair Co., 111., Medical Society, June 7, 1894.) 

Cleanliness is said to be next to godliness — a very old adage which I have found to 
foe no less true in the treatment of all diseases which have come under my observation. 
It is my custom to first make clean my patient, outside and inside so far as practicable, 
by the free use of pure water and good soap. I have never seen or had a bad result 
from the use of these agents. I am of the opinion that in many cases all the medicine 
that is needed is the free, judicious use of water, abstinence from food, plenty of pure 
air and sunshine. 

These agents, together with a clear conception and observation of the laws of 
hygiene will figure very conspicuously in the future of medicine. 

While I am a strong advocate of the free use of water in the practice of medicine, 
I also have confidence in the therapeutics of drugs, and as I believe, have seen many 
good results from the intelligent use of them. 

In the treatment of disease there are three distinct steps. They are; 1, correct diag- 
nosis — ascertaining the cause; 2, absolute cleanliness by irrigation internally and the free 
use of water externally, and by the use of disinfecting agents; 3, repair the damage — 
heal the wound — restore nature — rather assist nature in her work of reconstruction. 
This should be done by the skillful use of the tools best adapted to the work to be done. 

In treating diseases of the alimentary canal generally, and in the three following 
cases which I report to you I have endeavored to follow the foregoing principles. My 
results are all that could be desired. They have been both interesting and profitable to 
me, and I trust they may be of some interest to this society. 

Case i. — Miss Mary; aged 29; American; fawn type; medium size and rather 
stout; was taken at night with pain in the lower bowels, followed by watery stools. 

I was called in the early morning, March 15. Found her excited and suffering 
very much pain in the bowels; also complained of severe headache. Temperature was 
slightly elevated. Pulse regular, but rapid and weak. She gave history of having had 
several severe attacks of ulcerative colitis, during one of which she came very near to death's 
door. 

There was some tenderness on palpation and percussion over the major part of the 
.abdomen and the bowel was very active in evacuating itself. The stools were thin, and 
•continued mucus with a little blood. When food was taken into the stomach, especially 
.milk, it was usually ejected in curdy masses within a few minutes. 



i57 

The usual agents were used to abate the pain, to check the vomiting; also to restore 
the bowel to its normal condition. 

The pain was greatly reduced and the rebellious condition of the stomach almost 
entirely overcome; but the bowel persisted in its active work of draining the system. 
The stools became offensive, containing more blood and mucus. 

A portion of the lining membrane of the intestine about eight inches in length was 
passed with the feces the fourth day. Having a four ounce bottle of Glycozone, I con- 
cluded to try it. So other internal agents were discontinued, a 2-drachm doses of Gly- 
cozone given even r four hours in a wineglass of water. The bowel was washed out 
morning and evening with warm soap water, followed by an ounce of tepid water con- 
taining a half drachm tinct. opium. 

At the end of the first day after beginning the last method of treatment there were 
marked signs for the better; and the patient expressed herself as feeling less bad. The 
treatment was continued with constant improvement in the case until the Glycozone was 
all taken, at which time the bowel and stomach were under good control. Pain was all 
gone; and after a few days of convalescence the patient made a perfect recovery without 
any further treatment. 

Case 2. — Ely, aged 32, medium-sized man, general health uniformly good; black- 
smith by trade. First saw the case with Dr. S. at 5 P. M., March 30. 

On arrival at bedside of patient, I found him in what seemed to be a semi-comatose 
state. The odor of whiskey was very marked. Examination of the matter ejected 
showed it to contain blood and mucus. 

A few drops of chloroform with cold water was given, and a cold pack placed over 
the epigastrium to check the vomiting. The following powders were give.i to quiet the 
stomach and to move the bowel: 

]$ Calomel, gr. viij. 
Podophyllin, gr. ij. 
Subnitrate of bismuth, gr. xij. 
Bicarbonate of soda, gr. iv. 

M. Pulvis, No. 4. Sig. Dose, one powder every hour. 

The father, mother and wife of the patient gave the following history: 

"For the last five years the patient has been drinking whiskey, and for the last two 
years, in particular, he has been drinking too much. Last October he had an attack 
somewhat like this, but recovered in about one week. 

"His general health has always been good. He has been drinking too much every 
day for a week now — keeping his whiskey in the shop. He was well this morning. 
Worked in the shop until noon. Ate a hearty dinner, but was taken sick soon aftei eat- 
ing and in a short time began to vomit." 

Called again at 5 p. M. Found him quiet, but suffering. Left some Dover's powders 
to be given during the night if necessary. 

At 2 a. M., March 31, was called again. Found him excited and suffering very 
much. Quick pulse and slight elevation of temperature. Gave him hypodermic injec- 
tion: 

I£ Morph. sulph., gr. £. 
Atropin, gr. 1-150. 

His wife gave history of his vomiting at irregular periods until 10 P. M., after which 
time nothing would pass either up or down. Impossible to swallow water. Upon careful 
inspection the whole mucous membrane lining the mouth and throat as far as could be 
seen was in a state of hypertrophy. Indeed, it was simply cooked. (Pardon the use of 
the word, cooked; but it expresses the condition.) The stomach, also, was in a state of 
inflammation. What was to be done? 

Internal medication and alimentation was out of the question. Recognizing the 
emergency of the case, I determined, if possible, to dissolve the mucus about the 
iffected parts, and to attempt to reduce the edema of the membranes. 

The nose and throat, therefore, were sprayed every twenty minutes for awhile with 



i58 

Hydrozone and a 20 per cent, solution of the same used as a gargle every hour, until he 
could swallow water, which required forty hours. An enema of warm soap-water was 
given and repeated, which produced a soft stool; and he expressed himself as feeling 
better. 

The spraying of nose and throat, together with the gargle, also the enema, were con- 
tinued every day. The inability of the patient to swallow made alimentation by the 
stomach impossible, to say nothing of the inability of the stomach to perform the work 
of digestion. Boiled milk and warm soups were regularly given in small quantities by 
the rectum. 

On the morning of April 7, the whole lining membrane of the esophagus was 
expelled in the attempt to vomit. The membrane was neither broken nor perforated; 
but was turned inside out. I have preserved the specimen in an a'coholic solution; and 
take pleasure in presenting it herewith for your inspection and examination. 




"A" "B" 

Photograph of the mucous membrane expelled from the Esophagus of Ely. Cut "A" illustrates 
the ragged surface of the membrane as torn from the muscular coat of the tube. 

Cut "B" illustrates the smooth surface of the same membrane over which food was passed, the 
membrane being turned inside out, just as when expelled. The size of these cuts are two-thirds of the 
photograbh of the Esophagus. The cardiac end of the membrane being at the bottom of the cut in 
each case. 



There was some fever most of the time. The temperature running up as high as 
102. The pulse varied from normal to 90, and a few times went up to 100. 

The general condition of the patient was fairly good — indeed, much better than 
could have been expected. 

There was very little headache, but a lancinating pain in the left hypogastric region 
was greatly accelerated by coughing, and there was more or less tendency to cough 
during the first week. 

I might state here parenthetically that, in my judgment, the trouble in the side had 






159 

no connection with the condition of the mouth, throat and stomach; but, on the 
contrary, was entirely and wholly independent of it. 

The history given of the case showed the last named trouble to have been produced 
some five year ago by prolonged arduous labor in which the abdominal muscles were in 
a constant strain for hours. Since which time the trouhle has returned at different 
periods; and almost invariably following protracted, or great straining of the muscles 
in that regron. The treatment given was palliative. 

The odor coming from the mouth of the patient was offensive from the first, and 
continued to grow more and more offensive until after the expulsion of the membrane. 

The kidneys performed their work admirably well. The stools which followed the 
enemata of warm water were rather soft and of a greenish color. 

There was no hallucinations, no delirium; and for the most part sleep was good. 

To prevent septicemia, to assist nature in the work of reconstruction, as well as to 
counteract any miasmatic influence that might be present the following preparation was 
given: 

r$ Quininae sulphatis, J)ij. 

Acidi sulphurici aromatici, cc. v. 
Aquae camphorae, 
Aquae destillatae, aa § ij. 

M. Sig. One dessertspoonful every two hours, being alternated by half drachm 
doses of Hydrozone, 20 per cent, solution, given in a third of a glass of water. 

Gradually, but sfowly, the condition of the patient grew better, with the exception 
of one day, at which time he had no Hydrozone. The other medicine "Would not work 
without the gargle," as he expressed it; "But worked well together." 

Immediately after resuming the use of Hydrozone he began to feel better. Saw 
him April 9th. Found him in good condition. Pulse and temperature normal. Ex- 
pressed himself as feeling very well. 

He had been sitting up most of the time for several days. I recommended that the 
treatment should be continued for some time. 

A week later his wife called at my office stating that she thought he was doing very 
well. Since which time I have had no official report from the case. 

My candid opinion is, that of all the agents used, the one to which he owes the 
preservation of his life during the first seven days of the attack is Hydrozone. 

Case 3. — Bennie, littfe boy, aged 9 years, orphan, German, was brought to my 
office May 20. Had diarrhoea which had become chronic. Also had intermittent fever 
— mild form. He was very much reduced in flesh and emaciated. 

Various and numerous agents from the list of ordinary remedies were used during 
the four succeeding days; but the diarrhoea was growing worse rather than better. The 
stools became very numerous, the actions amounting to ten or twelve at night with as 
many more during the day. The malarial fever received appropriate treatment and was 
readily subdued. 

May 26 I planned a new treatment. The patient was thoroughly sponged from 
head to foot once a day with tepid alkaline water. The bowel was washed out clean 
morning and evening with soap-water, just warm enough to be comfortable to the patient. 
After the bowel was washed out, 2 ounces of starch water containing two drachms of 
Glycozone was thrown into the rectum, and left to be absorbed. The internal treatment 
consisted of a milk diet, fresh water to drink impregnated with Hydrozone, and dessert- 
spoonful doses of Glycozone taken every two hours during the day in a wineglassful of 
fresh water. 

Improvement began with this treatment. The skin and bowel was kept thoroughly 
cleansed every day as well as medicated, the bowel being irrigated twice each day. 
June 4, the child was reported well. His general health is rapidly improving. 

Good or bad, this treatment is purely original with me. 

What effected the cure? My answer is this: 

I. Removing the cause. This was done by abstinence from all solid food. 



i6o 

Aliment was restricted to small quantities of pure, fresh milk, beef and chicken soups, 
given at regular periods. 

2. By cleansing the affected parts, as before stated. 

3. By healing the wound. This was done by the use of Glycozone, which I have 
found to be one of the most reliable and rapidly-healing agents that I have yet used. 
The hydrogen was used as a disinfecting agent. 

May we not reasonably expect that during the remainder of the present decade, 
and for all time to come, internal as well as external cleanliness shall be to suffering 
humanity a boon — a heavenly unction. 

Note. — I have, for some time, substituted Ilydrozone in my practice instead of 
Peroxide of Hydrogen as formerly used. 

Hydrozone is "double strength" hydrogen peroxide — so to speak. In other words, 
it has twice the bactericide power, and, therefore, requires only one-half the quantity to 
accomplish the same results. 

It is not disagreeable to the patient when taken internally, if well diluted with pure 
fresh water. 



CHOLERA.— PREVENTION AND TREATMENT. 

By Elmer Lee, A. M., M. I)., Chicago, 111. 
(Reprint from The Chicago Clinical Review, for April, 1S93.) 

A mass meeting of physicians, for the consideration of the above subject, was held 
at the Great Northern Hotel, Saturday evening, March 18, 1893, under the auspices of 
the Practitioners' Club, of Chicago. There was a large attendance. 

Dr. C. D. Wescott called the meeting to order at 8:20 P. M., and Dr. DeLaskie 
.Miller was chosen Chairman of the meeting in the absence of Dr. N. S. Davis. 

Dr. Miller in his opening remarks said: This is an unexpected honor, to be 
called upon to fill the place of the gentleman who is unavoidably absent; but as the 
Chairman of this meeting is to be little more than a figurehead, I will accept the honor 
with thanks. This is an important meeting, and I trust that the attention and interest 
of it will be given to the gentlemen who will occupy the time. Without further remarks 
we will proceed to the business before the meeting. 

After remarks made by several medical gentlemen on the different phases of the 
subject of Cholera, Dr. Elmer Lee, of Chicago, read the following paper: 

The leading proposition suggested and tried in the treatment of Asiatic cholera, 
during the epidemic of 1892, in Europe, consisted of the following general plans. Early 
in the epidemic, lactic acid treatment was proposed on the ground that it would neutra- 
lize the akaline accumulations in the bowels, and so stop the multiplication of the bacilli. 

An Englishman, residing in Paris, considered Cholera a hyperemia of the spinal 
cord. His proposition was ice poultices continuously applied to the region of the whole 
spinal column. A small pamphlet was published by the doctor in defense of his con- 
clusions, and to present testimonials in favor of his congestion theory. As this system 
of management was not seriously considered by cholera physicians, its efficacy cannot 
be stated. 

The use of large doses of the Russian remedy, salol, the invention of Prof. Nenski, 
of St. Petersburg, grew in favor as a new remedy during the epidemic. The average 
result of cases so treated in St. Petersburg, and by my American colleague, Blackstein, 
in Baku, and in other provinces in Southern Russia, could not be said to be satisf actor)-. 
Finally, at the close of the epidemic, its influences had come to be considered less and 
less valuable — this, however, can be said — it was in all and all more largely used than any 
other new remedy. Still it would not be safe to put too much trust in it. 

Calomel was everywhere a remedy even more used than salol. Formerly this drug 
was used in very large doses, but last year it was the very small doses that found favor. 
Especially was this true in the treatment of cholera in Hamburg. 



i6i 

Of the surgical measures, the infusion of solutions of salt were most practiced. 
The solution consisted of distilled water in which was dissolved one-half of one per cent. 
of common salt. This liquid was warmed to the temperature of the blood, and either 
introduced directly into some large vein, or injected, with a long needle and a large 
barrel syringe, beneath the integument of the abdomen. The amount of salt solution 
used in either case would be from one pint to one quart each time. In one case treated 
at Hamburg as much as thirteen quarts of salt water were used from first to last. The pa- 
tient recovered. The subcutaneous injections were frequently followed by cysts and some- 
times abcesses appeared. Intravenous injections sometimes proved a godsend, but more 
frequently disappointment could be said to be the result. These injections were only used 
in the third period of the disease, or the stage of collapse, algidity or asphyxiation, at which 
period, it would be rather unreasonable to expect recovery by virtue of any treatment. 

The Italian treatment, as it w T as called in Russia, was much used and with frequent 
gratifying success. The practice was introduced by Prof. Cantani. It consists of a 
clyster composed of the following constituents. 

Boiled water or infusion of chamomile (warm), 2 litres. 
Tannin, 4 to 10 grammes. 
Laudanum, 5 to 10 drops. 
Powdered gum-arabic, 50 grammes. 

This or some part of this solution is occasionally passed into the rectum, to be re- 
tained if possible by the patient. In the experience of those who have followed this 
method of treatment, almost every case taken at the beginning of the disease has lived. 
It is certainly more reasonable in principle than simple drug management. 

Of the experiments of Ferran, of Spain, and Haffkine of the Pasteur Institute, 
much has been said, but what has been said has failed to bring conviction to my mind. 
As cholera itself cannot be said to protect one who has had the disease and recovered, 
against a second attack, then that which is less than cholera in influence cannot be ex- 
pected to do it. The seat of the disease is located in the intestines, and, so long as the 
infectious juices are there, the lymph vessels, in the processes of physiological function, 
will continue to infect the blood. Can we hope to thwart physiological action of ab- 
sorbents by hypodermatic injection of cholera culture, made at some time, it may be 
years previous to the date of the passing epidemic? The answer by my judgment, is 
that such expectations are flimsy. The caprice of .Stanhope at the Hamburg Hospital 
cannot seriously pass for an argument in favor of anti-choleraic vaccination. His inter- 
esting but widely exaggerated stories were the product of a newspaper's love forTsensa- 
tion, and profit of increased sales of newspapers. 

My own personal thoughts concerning cholera and the method of treatment, as 
practiced by me both in Russia and at Hamburg, during the epidemic of 1892, will oc- 
cupy the remaining time allotted to me. 

It is now well known that cholera is a disease of the alimentary canal. Its inciting, 
cause is believed to be a germ taken into that canal through the medium of food and 
drink. There its presence is protested against by the absorbent vessels, which elimi- 
nate from the food the nutriment for the body. The first symptom produced by foreign 
invasion in the intestines is a diarrhoea, which may preceed vomiting from one to three 
or even four days. If this be true, the bowels must be the seat of disorder, and the 
most direct method of reaching them by medication must be the best. If the stomach 
could be emptied of the foul material before the poison has passed further, there might 
be speedy relief and, indeed, no real cholera. After it has passed into the intestines, 
medicine administered through the stomach may be slow in reaching the seat of the 
disea.se, and even then can only mingle with the poison, holding out the hope that the 
one will be neutralized by the other. This hope, in truth, is seldom realized. But if 
the poison can be removed from below, the course is left clear for nature to recuperate 
itself. The diarrhoea is an evidence of the great exertion put forth by the organism to 
rid itself of the death-dealing agency, and probably it would be effectual in the great 
majority of cases, were it not that the nervous forces of the system are exhausted by the 



162 



terrible strain, before the required evacuation of the bowels is completed. A large 
irrigation of hot water, made soapy, preferably by neutral liquid soap, introduced into 
the colon through a suitable rubber tube, is the simplest, and I am prepared to say 
further that it is a more satisfactory way of treating cholera than any other with which 
I am acquainted. The time to begin the irrigation is at the very earliest possible mo- 
ment. Save the blood every single moment of infection by immediate action even if 
there is the faintest suspicion of cholera either with or without diarrhcea. In every post 
mortem seen by me in cases of death in which there had been no marked diarrhcea, the 
colon and intestines were filled with accumulations of choleraic matter, which swarmed 
-with coma bacilli. The rule from which there need never be deviation is to treat the 
patient by irrigation of the bowels and rinsing of the stomach without waiting for con- 
firmation of the diagnosis either with the microscope or by the culture test. The best 
part of the practice is always to save the patient, even at the expense of fine statistics. 
The accompanying illustration explains the manner of using irrigation of the intestines. 
Such apparatus is suitable for places of public treatment of the sick. In private prac- 
tice the syringe would take the place of the irrigating apparatus. 

The irrigation is accomplished by means of a soft rubber tube F, one meter in 
length and of suitable size to be introduced into the rectum, in front of the promontory 
of the sacrum, into and up through the sigmoid flexure and into the descending colon. 
This tube which is connected with a glass reservoir E, should not be too small nor too 




(Dr. Lee's apparatus for irrigating the intestines for the cure of cholera and other bowel diseases. 
Used first in St. Petersburgh during the cholera epidemic of 1802.) 

large in order to facilitate its introduction through the folds of the sigmoid portion of the 
lower bowel. In fact, the greatest difficulty to be encountered, is to successfully pass the 
tube in front of the promontory of the sacrum, and enter into the sigmoid flexure. The 
tube should be of proper firmness to prevent it from bending or buckling upon itself 
when the end (which in all cases should be rounded) comes in contact with the obstruct- 
ing folds of the intestine. 



i*3 

For internal treatment my experience taught me that the medicinal Peroxide of Hy- 
of Marchatid* ', given in cupful doses of the strength of 4 per cent. , or even much 
stronger, was a better antiseptic than any other drug heretofore known in the treatment 
of cholera. Then the treatment would be, first, immediate irrigations of hot water and 
soap, using from one to three gallons at a time twice a day for the first and second days. 
Once a day afterwards, if required, which is seldom the case. At the same time cleanse 
the stomach with medicinal Peroxide of Hydrogen* and hot water used freely — by urging 
the patient to drink. The feeding and nursing are the same as would be required by 
a patient suffering from septicemia or other prostrating disease. My belief is based 
upon personal experience, and the following surgical measures and medical treatment, 
viz.: Irrigation of the bowels, always first with hot water made soapy with neutral 
liquid soap or a good castile soap; second, cleansing and rinsing the stomach with 
hot water and medicinal Peroxide of Hydrogen*, continuing till it is well washed; 
third, food and nursing; fourth, -medicinal Peroxide of Hydrogen of ^percent, strength* 
given in cupful doses at intervals of two hours during the sickness till convalescence; 
fifth, meet the requirements as they come up, as would be done in any other grave dis- 
ease, using whatever personal experience has taught us to believe is good. Cleanse the 
bowels, wash the stomach, feed the sick, keep them warm if cold, and reduce excessive 
heat by the cool bath rather than reliance upon drugs, using anything in an emergency 
that is the easiest and the most accessible to procure. The cholera patient may be con- 
valescent inside of the first few days, or if not convalescent and not dead, the case goes 
into the typhoid state, after which convalescence may be deferred for several weeks, or 
death may be the conclusion. The temperature prior to the fifth day is generally 
subnormal or a little above, but on the fifth day marked exacerbation and elevation of 
temperature indicates the typhoid condition. 

The Chairman: It is a most fortunate circumstance that we are alive to-day. 
AVe must all of us feel confident that we have passed from the old to the new dispensa- 
tion, which cannot but strengthen our faith like the anchor cast within the vale. We 
know what cholera is; we know that we can limit its spread in our city. This is a great 
confidence, and will do much for the comfort of this community. This idea should be 
spread throughout the length and breadth of this great city. 

Note. — Since reading the foregoing paper, Hydrozone has been substituted by 
Dr. Elmer Lee instead of Peroxide .of Hydrogen for reasons given on page 39, article 
headed Treatment of Typhoid Fever. 



CHRONIC CERVICAL ENDOMETRITIS.— 

OSMOTIC TREATMENT. 

By Walter S. Wells, M. D., New York. 

(Reprint from the Chicago Medical Times, July, 1894.) 

Acute inflammation affecting the uterus, shows a marked tendency to invade the 
entire organ, and to involve both the body and the cervix. 

But chronic inflammation, being of a lower grade of intensity, is more apt to be 
limited to the mucous membrane of the body of the organ, or of the neck. 

There is, however, nothing absolute as to such limitation — sometimes subjacent 
parts being more or less implicated, and in other cases the mucous membrane of the en- 
tire organ may be simultaneously involved. 

The term, chronic cervical endometritis, is here applied to chronic inflammation of 
the mucous membrane extending from the os externum to the os internum. This con- 
dition, like many others, has been described under various titles, and is known as Cer- 
vical Catarrh, Cervical Leucorrhnea, and Endocervicitis. 

* Hydrozone now takes the place of Peroxide of Hydrogen, the strength is double, the dose one- 
half. See note. 



164 

It is regarded as the most frequent of all diseases of the female genital organs, and 
although not itself a malady of dangerous character, may give origin to some of the 
most serious and obstinate uterine disorders. 

The cervix uteri being exposed to injury during coition, — to laceration during par- 
turition, — and to irritation from walking, riding and lifting, it is not surprising that it 
is frequently the seat of disease. 

The chronic cervical inflammation is a frequent cause of menstrual derangements, 
and frequently produces sterility — the tenacious, thick glairy discharge from the cervi- 
cal glands preventing entrance of the spermatozoon. 

The cavity of the cervix uteri is described in text books as a fusiform canal measur- 
ing about one inch and a quarter, beginning at the os externum below and ending at 
the os internum above. The mucous membrane lining this cavity is estimated to con- 
tain in a well-developed virgin cervix, at least ten thousand mucous glands. 

The mucous membrane in which these glands caleld the glands of Naboth are im- 
bedded, is covered by cylindrical and ciliated epithelium and studded by villi, especially 
in the larger rugae. 

Occlusion of the ducts of these glands causes their distension with mucus, when 
they form small translucent cysts, and if they are large enough to project like peas from 
the surface are known as "ovula nabothi." 

The natural secretion of the cervical canal has been shown by M. Danne to be 
alkaline — while that of the vagina is acid. Cervical endometritis consists of inflam- 
mation of the structures named, the disease being one of glandular inflammation. The 
glairy mucous, which is secreted in large amount as one of the symptoms, is the charac 
teristic discharge in this disease. 

In patients who have died from some other cause, but having this disease also, an 
examination of the parts with a magnifying glass has disclosed the Nabothian glands 
enlarged and elevated, with their mouths dilated. 

In some cases there is granular degeneration, the villi or papilla; being involved. 
In time, an hypertrophy occurs in the villi, which increase in size, project like so many 
hairs from the surface, and give to the os and cervix the appearance termed granular 
degeneration. The condition affects the vaginal portion of the cervix principally, but 
may extend up the canal. Another pathological state may be found; an eversion of the 
os and lower portion of the canal to such an extent as to keep up inflammation there by 
the friction of the membrane thus exposed against the floor of the pelvis, rendering the 
case obstinate. The thick tenacious mucous which is poured forth is loaded with 
epithelium, and may be tinged with blood. 

The causes which predispose to th s disease are impoverishment of the blood, fre- 
quent parturition, subinvolution and tight lacing. The exciting causes are laceration 
of the cervix, flexions of the uterus, excessive coition, endometritis, injury and efforts 
to produce abortion and prevent conception, and the use of intra-uterine pessaries. 

Many of the causes mentioned would fail to produce it in a uterus which had not 
been prepared for their action by depressed conditions of the general system. Cervical 
endometritis may exist for a length of time before it is recognized, the patient not com- 
plaining of the discharge. The first symptoms probably, which do attract attention, 
will be dragging sensations about the pelvis, followed by pain in the back and loins, 
which will be aggravated by exercise. 

In time the leucorrhcea will be noticed, the discharge having come to resemble boiled 
starch or thick gum water, and often irritating the vulva and vagina to such an extent as to 
inflame them. Menstrual derangements may follow, the mense become too scanty or 
too profuse, too frequent or too dilatory. Occasionally decided dysmenorrhcea exists. 
Generally before the disease has continued long, the constitution of the patient becomes 
affected. She becomes nervous, irascible, moody, and often hysterical. Her appetite 
will diminish, and digestion grow feeble, causing impoverishment of the blood. 

This condition may continue for some time before complications supervene, but 
cystitis, cervical hyperplasia, and vaginitis may develop, proving very troublesome. 



««5 

Pain during sexual intercourse is regarded as indicative of the development of 
cervical hyperplasia, rather than of the endometritis, the former becoming added 
as a complication to the latter. Nausea and vomiting sometimes present themselves 
as symptoms, aggravating the disgestive disorder mentioned, as well as deteriorating 
the nutrition of the already impoverished blood. 

Upon making physical exploration, the patient lying on her back, the finger of 
the examiner will probably find the os uteri in its usual position in the pelvis, the weight 
of the uterus is not increased, the connecting tissue not being involved. The os may 
be somewhat enlarged, and its lips slightly puffed, or it may be roughened on account 
of granular degeneration. Sometimes, however, severe cervical endometritis may ex- 
ist without enlargement of the os or any trace of abrasion or granular degeneration. 

If the finger be placed under the cervix and that part raised by it, pain will be com- 
plained of, but it will be most marked opposite the os internum. 

The speculum will disclose the cervix usually somewhat enlarged, its tissue swollen, 
puffed, and intensely red if its investing epithelium is removed and there is hypertrophy 
of the villi. But cervical endometritis may exist, affecting the glands of the canal, 
without abrading the lips of the os, in which cases, without removing the plug of mucous, 
the os is seen to be no larger than it should be, its tissue is not reddened, no degenera- 
tion exists, nothing visible to explain the backache, nervousness and impaired nutrition, 
except the profuse glairy, tenacious discharge. 

The cervical cavity, in nulliparous women, may be found distended by the accu- 
mulation of the thick cervical mucous which is prevented escaping by a small external 
os. The cervix then has an elliptic form and is out of proportion to the size and shaed 
of the body of the uterus. 

Cervical endometritis is not a self-limiting disease, and if unchecked, frequently in 
multiparous women, passes into cervical hyperplasia, with displacement, and other ills 
which add to her annoyances. 

If the mucous which marks inflammation of the glands be slight in amount and 
not very tenacious in character, the prognosis is favorable, but if a considerable amount 
of thick, yellowish, stringy mucous hangs from the cervical canal, the prognosis is dis- 
couraging as to any definite time when a cure may be predicted, especially in a woman 
whose general health is impaired. 

Even in mild cases of some duration from four to six months or more will be re- 
quired to effect a perfect cure and even then a relapse is likely to occur. General and 
local treatment must go hand in hand in the management of these cases, as it is well 
established that by improvement of general health and hygienic surroundings, the local 
disease is benefited. 

It will probably not be amiss at first to relieve torpidity of the liver and constipa- 
tion by triturates of calomel, £ gr. at bedtime, followed in the morning by seidlitz salt 
or Rochelle salt, repeated from day to day, pro re nata. The value of quite warm 
water injections, 85 to 100 degrees F. or more, daily, and especially at bedtime, have 
been recognized from time almost immemorial. 

Great good is effected by suitably medicating the water for vaginal injections and 
for this purpose one part of zymocide to four or five parts of water at 100 degrees F. 
answers an excellent purpose, especially if we add half an ounce of boracic acid to each 
quart of the above mixture, in the bag of the fountain syringe generally employed. 

The tube (vaginal) should be of hard rubber, the central distal (uterine) opening 
closed to avoid throwing the injection into the uterine cavity, and about five inches in 
length. 

The dorsal recumbent position is preferred. With the hips elevated, the shoulders 
lying lower, the abdominal viscera gravitate toward the diaphragm by which the vagina 
is lengthened and its whole cavity may be flooded with the injection, a portion of which 
remains around the cervix until the ere " posture is resumed. 

The patient may be placed with her hips resting on the edge of the bed, with feet 



1 66 

on two chairs, and a rubber sheet so folded and placed beneath to elevate the hips, and 
its folds hanging over a tub below to catch the return fluid. 

Or, the patient may be placed by her nurse and supported in the knee-chest posi- 
tion, if it is thought desirable to further distend, the vagina with hot water disinfecting 
injections and to retain the same in longer contact with the os and cervix. 

The position itself, through the influence of gravitation, materially aids the recti- 
fying certain displacements of the uterus and diminishing pelvic congestions. 

Having used these injections for a few days, both in the morning and at bed time, 
the parts will be in condition to commence the Osmotic method of medication, which we 
usually commence by inducing profuse exosmosis of serum from the capillaries, to further 
unload the surrounding blood vessels and lymphatics and thus accomplish depletion 
and reduction of congestion. 

This has usually been accomplished by the topical application and retention around 
the cervix and os of pledgets of antiseptic cotton saturated in glycerine. But since we 
have used glycozone, which is glycerine subject to the action of ozone and made power- 
fully antiseptic by the Marchand method, we prefer it to plain glycerine, although the 
latter may be made antiseptic in a less degree by admixture with carbolic and boracic 
acids. 

In using glycozone we prefer the prepared lamb's wool, a suitable sized pledget of 
which is tied around with a string, for easy removal by the patient, and being saturated 
with glycozone is seized with the dressing forceps and passed through a widely ex- 
panded speculum and deposited directly to the os and cervix. 

If pain, locally, is a prominent symptom, £ to -i- grain of morphine may be incor- 
porated with the half ounce of glycozone used and the pledget is to remain in situ 
twenty-four hours. 

Belladonna or aqueous ext. opii may be substituted the former being credited by 
Trousseau and Ringer with properties, diminishing the secretion of the nabothian 
follicles, as well as acting as an anodyne. 

The pledget of glycozone will have exhausted its exosmotic influence by the end 
of twenty-four hours and being removed may be followed by an injection as before. 

The tamponade with glycozone may be repeated every third day, alternating with 
the injections of hot water with zymocide until the parts have lost the appearance of 
congestion, when the treatment may be extended within the cervical canal by means of 
the cotton wrapped hard rubber probe applicator. The distal extremity of the probe 
being coated with a thin film of prepared cotton, and the cervix having been cleaned 
and dried with absorbent cotton, the wrapped probe is dipped into the selected fluid 
and any excess pressed out against the walls of the vial and then gently passed into 
the cervical canal to the os internum, and allowed to remain a few seconds before with- 
drawal. 

Any overflow from the os should be wiped away. Many combinations have been 
tried. Iodine is preferred by some, it not being altered by the secretions of the cervix 
as most medicaments are. The officinal tincture of iodine is too weak. Churchhill's- 
tincture (iodine gr. xxv; potassic iodide, 3 iss; to alcohol, § i.), very much stronger is 
often to be preferred. 

A good tincture is one from Biiss to 3 i of iodine to 5 i of alcohol, with a small 
quantity of potassic iodide to facilitate solution. This can be applied to the cervix and 
canal once per week. 

Iodo-tannin (tannin dissolved to saturation in the foregoing tincture of iodine, 
may at times be beneficially substituted; also carbolic acid, liquefied crystals) used at the 
same intervals acts as an anaesthetic locally rather than as a caustic, is a favorite with 
some gynecologists. So also is iodized phenol (2 parts of iodine with eight parts of 
carbolic acid.) In these obstinate cases the physician will need to have several com- 
binations with which to alternate the local treatment. We have of late used with benefit 
the medicinal Peroxide of Hydrogen. The probe applicator is wrapped at its distaL 
end with a thin film of aseptic cotton and being dipped into a solution of equal parts of 



167 

the Peroxide of Hydrogen and zymogen, the probe is gently passed up and down in 
the cervical canal and renewed as long as the foamy discharge shows the presence of pus 
or the canal is cleansed. 

We then select a suitable sponge for osmotic treatment, one sterilized and bleached 
by the Marchand method and with its string attachment for easy removal, saturate it 
with equal parts of zymocide, Peroxide of Hydrogen and warm water, pass the same by 
aid of dressing forceps up through a widely expanded speculum in contact with the os 
and cervix, leaving it there for about twenty-four hours. 

The patient then removes the sponge by its string and has it cleaned in warm, 
weak ammonia water, and it is ready to be again medicated and adjusted as before. 

Perhaps a more efficient method of bringing the Peroxide Hydrogen within the cer- 
vix is by means of the cervical syringe, first devised, [ believe, by Munde. This appli- 
cator syringe with its distal end coated with a film of aseptic cotton and charged with 
the Peroxide of Hydrogen and zymocide aa q. s., the end is passed within the cervix up 
to the os internum. A slight depression of the piston forces out a small quantity of the 
fluid which being retained in the enveloping cotton holds the liquid antiseptic in close 
relation with the Nabothian follicles to be passed over them frequently, so as to bring 
the peroxide thoroughly in contact while the foamy discharge indicates the presence of 
pus in the cervix. 

After this direct medication of the cerv'cal canal, the osmotic sponge saturated as 
before, may be left in apposition with the os for the succeeding twenty-four hours. 
During this local medication the general nourishment of the patient, it will be inferred 
from what has been said, must not be neglected. 

Profs. Thomas and Munde says that if they were restricted to a choice between local 
and constitutional treatment in these cases, they would choose the constitutional, unless 
the local treatment were a surgical operation to remove the entire lot of glands. 

Having chosen a suitable bill of fare, digestion and assimilation may be promoted 
by administering after each meal a tablespoonful of elixir of peptenzyme and one at 
bedtime following a glass of milk, many patients, as well people, sleeping better after 
taking a little light nourishment at bedtime. 

This new digestant, peptenzyme, contains the concentrated extracts of all the diges- 
tive secretions furnished by nature for the digestion of a mixed diet. 

Its use with food, especially cream, which it rapidly digests, as well as prepares 
fats for assimilation, will soon overcome the dyspeptic condition and impoverished blood. 

Cases will occasionally be found in which nothing, not even both constitutional 
and local treatment will put a stop to the discharge from the Nabothian glands and as a 
dernier resort the late Dr. Sims in such obstinate cases dilated the cervix, and by means 
of the sharp curette, scraped away completely from the canal the entire mucous lining 
with its thousands of Nabothian glands. 

In very obstinate cases of this disease there is occasionally some other redundant 
growth besides the Nabothian follicles which may be improved by removal, as cervical 
hypertrophy granulations around the os and mucous polypi. 

After even such small operations the patient should be kept in bed and antiseptic 
anodyne mixtures used upon the osmotic sponge as dressing to the wounds. It should 
be remembered that in using the sponge to a raw surface that a cut surface of the sponge 
should not be applied, or adhesion would occur. The natural surface of the sponge is 
not liable to adhere. 



LOCAL TREATMENT OFUTERINEANDVAGINAL DISEASES. 

By WILLIAM C. WILE, A. M., M. D., LL. D., Danbury, Conn. 

(Reprinted from the New England Medical Monthly, September, 1894.) 

There is no class of cases that come under the doctor's care, that cause him so 

much trouble as those called female complaints, and the more advanced we progress 

towards civilization, the more frequent becomes the call to do this sort of work, and the 



i68 

more obstinate they seem to cure. This condition of affairs is largely due to: I. 
Corset wearing. 2. The desire to avoid child bearing, with its shifts and expedients, 
hot water, cold water, medicinal washes, withdrawals, et al. 2. Uncleanliness, not 
keeping these important parts in a sanitary condition. 3. Too rapid child bearing. 

The gynecological surgeon has used his knife so recklessly about this neighborhood, 
that the revolt has come and the cry is, halt! and in emphatic tones. The days of 
pessaries are numbered, and only in exceptional cases are they used by any body now- 
a-days, while practical medication deducted from experience is in the van, with thera- 
peutical local applications, which do more for diseased vaginal and uterine tissues than 
all other methods combined. Chronic inflammations either simple or catarrhal of the 
cervix, cervical canal, endometrium, and vagina are amongst the most obstinate of all of 
this class of cases to treat, and give the patient and doctor both a deal of trouble. 

My method of treatment for the last two years has been as follows: Correct what- 
ever is out of gear in the general condition, hot water douches from 10 to 20 minutes 
twice a day. Immediately after this douche with aglassor rubber syringe use one ounce 
of Hydrozone and one ounce of water, allowing this to remain while the patient 
lies in the recumbent position for ten minutes. Wash vagina out with water and 
introduce clear up the cervix one of those indispensable little tablets, Micajah's 
Medicated Uterine Wafers. These I have found simply invaluable in the treatment of 
these cases. A cure is readily affected and the patient and doctor alike delighted. 
(See articles headed, "Treatment of Vaginitis by Peroxide of Hydrogen (Medicinal)," 
by Herman L. Collyer, M. D., of New York, p. 126; "Peroxide of Hydrogen in 
Gynecology and in Obstetrics," by Egbert II. Grandin, M. P., of New York, p. 79. 



TUBERCULAR ADENITIS OF THE NECK. 

HOSPITAL CASES. — FROM THE ST. LOUIS FEMALE HOSPITAL. 

By R. M. Kiki.kv, Superintendent. 
(From the Courier of Medicine^ St. Louis, Mo., July, 1S94.) 

L. I. single; age 20; occupation servant; admitted into Female Hospital June I7> 
1893. History: Had given biith to a child sixteen months previous. The glands of 
the neck began to enlarge two years previous. When admitted to hospital had an 
itching dermatitis of flexor surfaces of both fore-arms, also of the neck. 

The enlarged glands are very tender and painful, at times suffering intense. After 
using anti-syphilitic remedies for one month without avail, extirpation was determined 
upon. Operation: On July 21st the superficial chains were removed, six in number, 
under chloroform. Incision was made along posterior border of sterno-mastoid down 
to diseased tissues, which were then enucleated. Capillary oozing was quite free but no 
vessel of importance was severed, although the sub-clavian could be plainly seen, pul- 
sating in the lower angle of the cavity left by the removal of one of the deep glands. 
As far as could be ascertained, no morbid tissue was left behind in the dissection, which 
was tedious on account of adhesions to the glands. The wound was closed with inter- 
rupted silk sutures, without drainage. The cavity soon filled with blood and the line 
of incision was painted with iodoform-colodion and an ice-bag applied. Time required 
for operation, one hour. Patient reacted well. 

The removed glands were tuberculous in various stages of the disease, two of which 
had undergone caseation, and two others had broken down and were apparently about 
to suppurate through the adjacent parts at time of operation. 

On July 26th the stitches were removed, union was perfect except at dependent 
portion, where there was a superficial nidus of pus. Washed with Marchand 's Peroxide 
of Hydrogen and applied dressing — bichloride gauze. 

August 2nd, wound healed. August 4th, patient discharged, well. 



169 



THIERSCH'S GRAFTS IN EXTENSIVE DESTRUCTION OF 

SOFT PARTS ABOUT LARGE JOINTS. 

By Henry W. Coe, M. D., Portland, Ore. 

Reprinted from the Medical Sentinel, of Portland, Oregon, September, 1894. 

Read by title before the seventh annual convention of the National Association of Railway Surgeons 
at Galveston, Texas, May, 1894.) 

For a comparatively recent procedure and an operation producing such satisfac- 
tory results, Thiersch's method of skin grafting occupies very little space in medical 

books and almost none in 
medical journals. 

It seems to the writer 
that no method in surgery 
has been brought forward 
in recent years which, in a 
small way always, and in 
many instances in a larger 
degree, produces results 
which afford such general 
satisfaction as those given 
to us by the use of this pro- 
cess of Thiersch. Espec- 
ially is this true in relation 
to the treatment of injuries 
involving the destruction of 
considerable areas about 
the larger joints. 

We often see the con- 
torted results following the 
older methods of treatment 
in cases of destruction of 
large portions of skin. 
Especially deplorable have 
been the results obtained 
after any other methods of 
treatment, when the loss of 
integument has occurred 
about large joints. 

It has been my good 
fortune to meet a number 
of injuries in which the 
integument and underlying 
soft tissues about great 
joints have been involved, 
and in which I have, during 
these late years, been glad to 
Figure i. find in Thiersch's method 

a satisfactory treatment. 
vl say "good fortune," for the results are so satisfactory that the keenest gratification 




170 

must result from one's care of such cases. My excuse for this paper is the dearth 
of literature upon this important division of modern surgery, and the desire to present 
two cases in illustration. 

Case i. A young man, 20 years of age, a kneader in cracker factory, on Oct. 
( 16, 1893, in feeding the dough, had his hand and arm drawn between two rapidly 
, revolving rollers up to a point several inches above the elbow joint. His desperate 
effort to withdraw his arm, with the crushing force of the machinery and suction of 
the passing dough, severed the skin above the elbow, except a small shred upon the 
inner aspect of the arm. At the time of the accident this isthmus was put upon the 
stretch, the forearm being partially flexed, and the integument was drawn down over 
the forearm and wrist much like an everted gauntlet. 

The patient was taken to the hospital at once, where the grease and other dress- 
ings, which had been applied by fellow workmen, were removed and the skin replaced 




Figure 2. 
as carefully as possible. The wound was kept clean, and after three weeks the tissues 
destroyed by the force of the injury and loss of blood supply were removed, the gran- 
ulations scraped down, and the raw surface, which at this time completely girdled the 
arm at the elbow joint for a space of from three to six inches, was, at one sitting, com- 
pletely covered with grafts taken from the inside of the patient's thigh. Although 
only about two-thirds of the grafts "took," the adhering portions were so distributed 
and so loosely applied that the natural contraction of the tissues, together with their 
marginal growth, soon covered the wound with new skin. The contraction which 
naturally took place where grafts did not adhere took the "slack" out of the loosely 
placed grafts, so that the results were highly gratifying. As the grafts were applied 
longitudinally upon the arm, any contraction the result of cicatricial tissue formation 
was not so situated as to act as a band about the arm. 

A wound of this nature under the ordinary methods formerly in vogue, and, for 
that matter, under methods often employed even at the present time, would have left 
an elbow joint covered with dense cicatricial tissue, to shrink, harden and crack, and 



i?i 



seriously abridge the action of the joint, as well as to interfere with the blood supply 
to the parts below the seat of constriction. 

At this time, six months after the operation, the young man has as free use of his 
injured elbow joint as he has of its uninjured fellow. The skin over the region is 

loose, and has quite a nat- 
ural appearance, and the 
circulation below the seat of 
injury is not interfered with 
in the least, and the man is 
now working again at his 
trade. 

The first illustration 
shows the wound as it was 
three weeks after the injury, 
and at a time when the 
dead skin, drying up and 
shrinking, was about ready 
to fall away. The forearm 
was still swollen, but the 
tissues, up to the line of 
demarcation, were otherwise 
in a healthy condition. 

The second view shows 
the elbow flexed to a similar 
degree as in the former view 
of the arm, with the wound 
all healed, excepting a smalL 
portion of the outer aspect, 
which is closing up by mar- 
ginal skin extension. This 
view was taken about three 
weeks after the grafts had 
been applied. 

Case 2. A boy, 16 
years of age, whose knee 
came in contact with a set 
of powerful cog-wheels, 
and, as a result, a consider- 
able amount of skin was 
torn away. 

The skin grafting in 

this case was done upon the 

superficial fascia four days 

after the receipt of the 

injury. The time between 

the date of the injury and of the operation was consumed in attempting to remove the 

oil with which it had been dressed, and otherwise make the wound aseptic, the wound 

being dressed several times a day with peroxide of hydrogen. 

The grafts took at once, and the entire surface was healed in about ten days, 
excepting two spaces of about a square inch each, which required four weeks to cover 
with cicatricial tissue by marginal extension, while fifty times as much surface adjoin- 
ing had been covered with soft, pliable integument in a few days only. 

The outcome in this case manifestly demonstrates again the happy results to be 
obtained by the use of Thiersch's grafts after injuries about large joints, in permitting 
free joint motion and circulation. 




Figure j. 



172 



The views exhibited in this case, recently taken, eighteen months after the receipt 
of the injury, show the new skin (cut 3), the leg being flexed upon the thigh at right 
.angles; and, again (cut 4), the new tissue picked up by the thumb and finger to 
.demonstrate its soft and pliable condition, even over a half -flexed knee — a procedure 
which cannot as readily be demonstrated upon the normal skin of a flexed knee, as any 

one can ascertain by at- 
tempting to pick up the 
tissues over his own knee. 
I believe that my suc- 
cess in the application of 
Thiersch's grafts has been 
largely due to the free use 
of peroxide of hydrogen 
( Marchand's) in dilute form, 
used not only before the 
grafts were placed upon the 
broken surface but also 
dailv thereafter, to carry 
away promptly any broken 
down tissues and to remove 
any discharge of a suspici- 
ous nature. Even when 
pus microbes have found 
entrance to such a wound, 
by the judicious use of this 
dressing the greater portion 
of the grafts may be saved 
and the melting down pro- 
cess aborted. 

Later in the treatment 
I have found the balsam of 
tolu, upon lint, an excellent 
dressing to strengthen the 
graft, and if any open por- 
tions are present, as may 
be even under favorable 
circumstances, such a dress- 
ing will hasten the process 
of granulation. 

One point that I desire 
to emphasize is that the 
grafts should be lain on 
parallel with the long axis 
of the limb, especially over 
a joint. By this means, 
even if but a portion of such 
grafts become adherent, the 
-cicatricial tissue is broken by loose strips of skin up and down the limb, whereas, if 
placed over the joint, encircling the same, the failure of a single graft may result in 
the formation of a band of cicatricial tissue, entirely or partially encircling the limb 
-and interfering more or less with its action and blood supply. 




Figure 4. 



173 

SCARLET FEVER. 

By JAMES S. KENNEDY M. D., Chambersburg, Pa. 

(Reprinted from the Nevj England Medical Monthly, December, 1894.) 

So much has been written lately concerning "scarlet fever" that the busy prac- 
titioner passes to the next page when his eye meets with the above title but to those 
who have the good of humanity at heart, I beg for a hearing. 

This section of the state (Penn.) has, since May last, been cursed with an epidemic 
of "scarlet fever," many cases being malignant in character. This contagious exan- 
thema as exemplified here, has been remarkable for the length of time intervening be- 
tween the subsidence of all symptoms and the desquamation. In some cases desqua- 
mation did not commence until the twenty-first day and in others it was six weeks be- 
fore it was completed. The Health Board (God save the mark) allowed the return of 
all the scholars to the schools without respect to the symptoms in twenty-one days, and 
in this way contagion was rapidly disseminated through the medium of the common or 
public schools. 

The forms of this dreaded disease, as generally accepted, are simple, anginose and 
malignant, and in these authors differ widely in characteristics. Most of the cases 
coming under my notice were of the pseudo-membranous anginose variety. The divisions 
given above, are in my humble opinion, far from correct, nor are they consonant with 
the nature of the disease. Scarlet fever is a single and unvarying disease, differing 
only in degree of severity, produced by one and the same species of bacteria, same in 
course, requiring no more than does typhoid fever to be divided and semi-divided 
simply because it differs in severity in different subjects. Look at the picture of the 
bacteria. These are the germs that do the damage and there is no doubt that they are 
found in every case of this specific disease, either simple or malignant. The essential 
element of this affection is an inflammatory action of the mucous membrane alike in 
each case and there never was a well authenticated case, where this inflammation was 
not present to a greater or less extent. It may be so slight as to cause no uneasiness 
to the patient or even escape the notice of the physician but it is there all the same, and 
is always shown under the "microscope." 

As to the anginose and malignant type, as they are usually called, the names are 
of little value for in all grave cases in which death was not due to cerebral invasion, by 
1 he third or fourth day, there developed a dangerous anginose inflammation, which 
although of the anginose vaiiety still was malignant also in character. Its powers of 
contagion are surpassed by none and its propagation and dissemination by air currents,, 
the physician, visitors, sewage, and a thousand and one other means cannot be success- 
fully combated. There can be no doubt that the activity of its poison remains for an 
indefinite period of time. For instance this case came under my observation: A cer- 
tain church was preparing a box to be sent to a missionary in the South and for this- 
clothing, etc., etc., was requested of the congregation by its pastor. A mother who had 
lost her onh" child by malignant scarlet fever, over a year ago, had preserved a doll and 
some fine underclothing as mementoes. These articles were stored in a close fitting 
cedar chest, in the garret. The touching appeal by the minister, influenced her to 
donate these sacred treasures, and they were included in the box. The missionary's 
child wore the clothes and played with the doll — contracted scarlet fever — died, and 
strange to relate it was the only case, far or near, noi was there any further develop- 
ment of the disease in that vicinity. 

The exact duration of the septic influence is as yet unknown and no matter how 
much care is taken, it can be carried away by visitors. No one realizes it more than 
the writer who taking ever)' precaulion, such as baths, change of clothing and disin- 
fection yet carried it to one of his own children, who was too young to get it from any 
other source. On the other hand we have known children constantly exposed to its 



174 

dangers escape entirely. This part of the subject has not been as thoroughly inves- 
tigated as its importance demands and if our scientists would give more of their 
time to such practical questions as "public hygiene" and less to investigations that 
-will not do humanity one iota of good, better would it be for the public. Whatever 
may be the activity of this virus it is an indisputable fact, that it can be disseminated 
by the clothing of the physician -and others, bedding, furniture, and desquamation. 
As to its not attacking a person a second time, I believe it does so more frequently 
than is supposed. I am attending a patient now, who one year ago had this disease 
without one single symptom absent. Her sister who slept with her a year ago escaped 
the infection at that time, and when this attack developed she was sent away and after 
an absence of seven weeks she returned home only to contract scarlet fever in five days 
afterwards. I believe that no matter how severe the disease is in a family the consti- 
tution must be in a certain condition to receive, retain and develop the poison. 

The age of five years and under, has in my experience produced the greatest 
number of cases, and I have known of a death at thirty-eight years. Sex does not 
seem to exert any influence, but most of my cases this summer and fall have been girls. 
One thing I have never seen noticed is the fact that the person taking the greatest 
interest and personal care of the patient is very prone to suffer from aggravated sore 
throat, of a specific nature. Some others of the family may suffer the same way. 

The symptoms of this disease are so familar to every practitioner that it would be 
useless to mention them, but as to the treatment each has his favorite — mine is as 
follows, nor do I claim anything to be strictly original: From the first rise of temperature 
and the slightest flush of the fauces, I give aconite, gtt. ij-iv, either in tablet form or 
tincture, every two hours, followed by belladonna the same dose, one hour after each 
dose of aconite, until the rash is thoroughly out from head to foot — then the belladonna 
is dropped and acid carbolici, § ss, olei olivse;§x. M. Sig. Anoint all the body 
except the face (on which pure olive oil is used), twice daily — followed at night by a 
tepid bath — where the cerebral symptoms preponderate, I give in connection with that 
above, a suppository containing ext. hyoscyami, gr. ss-j, ext. cannabis indies, gr. 
:£— j. camphone monobrom, gr. ii-v, lupulin, gr. v-xv. M. Sig. One night and 
morning. This will allay to a remarkable extent the cerebral symptoms such as 
delirium, wakefulness and low mutterings, and prevent any tendency to convulsions. 
For any stomachial symptoms, Glycozone, 3 j, aq. distillata, 3 iij. Glycozone is a 
powerful oxidizing agent and in contact with the germs destroy them. The above dose 
may be given every three or four hours. It causes no action on the heart, kidneys or liver. 
The local treatment is of the greatest importance, the fauces should at the first 
indication be swathed externally by a large silk handkerchief saturated in cold water, 
and over this a woolen bandage to prevent its too sudden evaporation, this is to be 
repeated every two hours until amelioration of the inflammation is noticed. Besides its 
local benefit, the temperature is also reduced — sponging over one portion of the body 
at a time is beneficial. Next in order in importance are remedial applications, and to 
these specially is this article directed. Hydrozone is by long odds the best local appli- 
cation and constitutional remedy we have in the whole range of materia medica. It 
has done wonders and will do wonders for you, my skeptical brethren, if I can only 
persuade you to use it. The following is the proper strength, viz: Hydrozone, 3 ss, 
aq. distillata, § iij— vj. M. Sig. Spray the throat, fauces and nasal passages thor- 
oughly every two hours. In this last mentioned medicine we have a comparatively 
recent addition to our weapons to combat this scourge, and as a germicide annihilator 
it has no equal and in no disease is this so well shown as in the above named. It pos- 
sesses virtues peculiar to itself, and no remedy will give the physician, and what is of 
more importance, his patient, so rapid and beneficial a result as "Hydrozone." Caution 
should be used in the manner of exhibiting this oxidizing agent, and only an apparatus 
of glass or rubber should contain it. A glass spoon for internal medication and a glass 
and rubber atomizer for the spray. No matter how severe the inflammatory process is 
in the fauces, or how much mucus is thrown out, the spray in a short time will change 



the character of the discharge and give a healthy tone to the membrane, and on the 
second day of use the entire buccal cavity will present a clean healthy color with the 
inflammation and breathirg relieved, and temperature reduced. Saturate the fauces 
with the spray, and the bacteria present and forming will certainly be destroyed. 1 ry 
it once gentlemen, and I know the death rate wiil be reduced and this will not be written 
in vain. 

The action of hydrozone when brought into contact with bacteria of any description, 
internal or external, destroys them by decomposition almost immediately. Nascent 
oxygen is liberated, the albuminoids of the diseased part coagulated, the pus corpuscles 
destroyed, and those in formation utterly routed out of existence. It is energetic, 
destructive, with absolutely no toxic effect, but at the same time, on account of the 
chemical action on the albumen, it should not be injected into the circulation. In a 
voluminous table of bactericide potency, hydrozone stands first, the biniodide of mer- 
cury second, glycozone third, with chloride of iron twenty-five on the list. It has been 
found that lime water, soda bicarbonate, thymol, and eucalyptus have no action on the 
microbes of pseudo-membranous anginose, when they are once developed, but may exert 
a mild preventative action. Such articles as potash permanganate, hypochlorite of lime, 
bichloride of mercury, carbolic acid and silver nitrate, do destroy the bacteria, but they 
are dangerous to the life of the patient, whilst glycozone and hydrozone are perfectly 
harmless. In the table of comparative strengths of the different germicides, it has been 
shown that hydrozone is twice as strong as Marchand's Peroxide of Hydrogen (medicinal) ; 
3 times as strong as bichloride of mercury; 5 times as strong as silver nitrate; io times 
as strong as iodine; 28 times as strong as iodoform; 128 times as strong as carbolic acid. 

By glancing over the above you will see what a valuable adjuvant we have in the 
treatment of scarlet fever. 



REPORT OF A CASE OF EXTENSIVE GUNSHOT WOUND. 

(Published by The Journal of the American Medical Association, December, 1894.) 
By F. II. BROBST, M. p., Reading, Pa. 

On Aug. 2, 1894, I was summoned in great haste to see Mr. G. B., who met with 
a dangerous accident half an hour previous to my arrival at his residence, by a dis- 
charge of a full shell, containing No. 8 shot, from a breech-loading shotgun, into his 
left side. Upon examination, after anesthetization by the assistant physician, I found 
the whole contents of the shell, containing about two hundred and fifty shot, had entered 
three and three-fourth inches to the left of mid-sternum, between the seventh and eighth 
ribs, fracturing the ninth, eighth and part of the seventh ribs to minute pieces, tearing 
and lacerating the pleural peritoneum and diaphragm ; lung and liver protruding, and 
impregnated with several shot. 

At first sight the case was thought and expected to be entirely hopeless. How- 
ever. I was determined to do all that could be done, so I excised a great deal of lacerated 
marginal tissue. I extracted all the pieces of bone obtainable, with numerous shot, 
and shreds of clothing from lower left lobe of lung and liver; washed out the peritoneal 
and pleural cavities with a warm bichlorid of mercury solution, 1 to 2500, but could 
hardly control capillary oozing until, as a last resort, I applied hydrozone half diluted 
with water, which admirably controlled all capillary oozing, and at the same time acted 
as a strong disinfectant. 

After a thorough cleaning and removal of lacerated tissue, I brought the edges 
together and coaptated with silk sutures after inserting two drainage tubes; one under 
the lower lobe of the left lung and the other under the liver from which 1 ascertained 
there was absolute drainage. The external dressing was composed of iodoform gauze. 
I prescribed internally brandy, belladonna and quinin and a bland but nutritious diet. 



176 

On the third day, I found ray patient restless and coughing with hematemesis and 
fever. Upon this I removed the dressing and washed out the abdominal and thoracic 
cavities with hydrozone in solution through the herein mentioned drainage tubes, and 
reapplied another antiseptic dressing, from which time the case made a remarkable for- 
ward progress until about the fifteenth day, when again the patient began to show some 
internal disturbance that on the eighteenth day proved to be an abscess on a large scale 
in left lower lobe of lung; this ruptured spontaneously three days later, leading to pro- 
fuse purulent expectoration (undoubtedly a result of remaining shot, and small frag- 
ments of bone) breaking down the patient's vitality very much for a time which, how- 
ever, was soon repaired with quinin and iron, and now the patient is absolutely cured. 

I merely report this remarkably unusual case to show what can be and often is. 
done to apparently hopeless cases. 



NEW THERAPEUTICS IN HAY FEVER. 

By ALEXANDER RTXA. M. D., of New York. 

(Published by the Medical Summary of Philadelphia, Pa., for December, 1S94.) 

For a number of years I had the opportunity to pay particular attention to a case 
of hay fever of the worst kind. The case was in my own family, a brother-in-law, who 
is living in my house. He is forty-five years of age, weight about 220 pounds, and is 
a six footer. He contracted the disease about fifteen years ago, in Chicago, while 
attending a camp meeting of the Knights of Pythias. Since then it has appeared every 
year with the punctuality of good clock work, on the nineteenth of August. Early in 
the morning, rain or shine, the sneezing commenced with the vehemence of a volcano 
in full eruption, as the first symptoms of the disease. The eyes are usually swollen 
and suffused in the inner canthus. There is a feverish, accelerated pulse, and a rise of 
temperature to 101 5-10 or more. However, it is not my intention to give you the 
etiology, pathology, symptoms, etc., of the disease; my object is to impart to you my 
successful treatment. 

I recollect my first experience with the case. T was called to the patient late in 
the night, at the period of the hay-asthma. He returned from the White Mountains 
where he used to spend the season, too soon, and got this attack. I found the gentle- 
man standing at the foot of the bed holding on to the woodwork and breathing like an 
aggravated bellows. Having no experience in the treatment of the disease, being my 
first case I ordered a wash-bowl of hot water, in which I placed his hands. After sl 
short while the intense dyspnoea was relieved, the respiration easier, so that he could sit 
down on the lounge. I now ordered a hot drink, hot water with brandy, almost half- 
and-half, still keeping his hands in the warm water. After a while I had the hot drink 
repeated, and in an hour he fell asleep on the lounge. The next morning he was sur- 
prised at the efficacy of my remedy, which gave him several hours of rest. 

Before I visited my patient I stormed all the hand-books on the subject, and took 
along a vast amount of prescriptions, which were recommended by the great authors, 
but they all failed to help the asthma. The paroxysmal attacks returned upon the 
slightest change in the weather, and the asthma run its self-limited course, in spite of 
all my remedies. That was six years ago. Since then I experimented with the good 
man, who was a patient subject, with all available drugs and medicines. I cauterized 
his nostrils, burned it with the thermo, and galvano cautery, brushed it, washed it, 
pencilled it, and still the next year the hay fever returned with the same vehemence 
and on the same day. Certainly I gave him relief, every year more, but to stop the 
out-break of the disease, I succeeded but for the last two years. 



i77 

My mode of treatment to prevent or abort the disease, consists of the following: 
Three days before the onset of the disease, I commence to wash the inner nares with 
a solution of Peroxide of Hydrogen (Marchand's), one part of hydrogen, and two parts 
of boiled water. This year I used Hydrozone, a new preparation, which has the 
double strength of the former, and is one of our best germ killers. I took ofie part 
of Hydrozone to three or four parts of water, according to the indication, three or four 
times a day. I use a nasal douche holding one pint ol the fluid. By this process I 
suceeded to prevent the outset of the disease in all my cases. There is but very little 
irritation of the nose present which causes the patient hardly any trouble. However, 
for those most sensitive I have the following prescription: 
1$ Acid, boiacic, gr. vii-j. 

Sol. cocaine hydrochlor, ^ ij. 
(Five per cent.) 
M. Sig. Use in atomizer. 

The nasal symptoms, or the hay fever, proper, has a duration, according to my 
observation, of about two weeks. After the expiration of this time, the hay asthma 
sets in , and two days later the hay bronchitis follows. Up to the past year I have not 
succeeded, in spite of all my efforts, to prevent this stage of the disease. Last year 
and this season, however, I succeeded rationally with the following remedies: My 
observations of former years taught me the lesson, that when this period approaches, 
certain branches of the bronchial tubes get clogged up with tenacious mucous, which 
none of our expectorants could dislodge in a hurry. I succeeded but once with a des- 
perate dose of apomorphia to remove this obstruction and the asthma disappeared like 
magic. However, in a short time it re-established itself and kept tight for some ten 
days and sometimes to the end of the season, of course with more or less severity. 
Considering this pathological condition, I started in right at the time when the hay 
fever should appear with the administration of the following prescriptions: 

R Iodide of ammonia, 3 j. 

Fl. ext. grindelia robusta, 3 iv. 
Fl. ext. yerba santa, 3 iv. 
Aq. q. s. ad., § ij. 
M . Sig. A teaspoonful four or five times a day. 

For the .first week, while the second week I ordered to be taken every three hours 
in teaspoonful doses adding yet the following medication: 

R Terpin hydrate, 3 j. 
M. Fiat capsule Xo. xii. Sig. Two capsules every two to four hours. 

These medications acted like a charm and prevented the asthma during the entire 
season. It seems to act in the way of preventing any accumulation of the discharges 
in the bronchial tubes and branches. The last stage of the disease, or the period of the 
bronchial catarrah, I have, thus far, not succeeded to avert, notwithstanding that there 
is no accumulation of mucous. However, as it forms the mildest part of the disease, 
the patient cares but little for the cough, which can easily be controlled by small doses 
of codeine. or morphia. Stimulating drinks are beneficial. Grogs and punches as well 
as good wines are advisable, all through the different stages of the disease. The in- 
testinal tract should be kept in order and late or heavy suppers prohibited. In some of 
my milder cases patient attended to his business during the whole period, and was not 
compelled to stay in the house like in former years. 



i 7 8 

PELVIC PERITONITIS WITH RESULTING ABSCESS. 

By F. P. LEFFERTS, M. D., Belyidere, N. J. 

Read before the New Jersey Homoeopathic Medical Society, October, 1894. 

(Published by The Hahnemannian Monthly, of Philadelphia, Pa., January, 1895.) 

This case is presented not because of anything remarkable in the treatment or in 
the results attained, but rather that pelvic abscess in not very common; to emphasize 
the tediousness of such cases, and to refer to the local treatment which seemed of bene- 
fit, and to see whether any can give suggestions in the way of an improved treatment. 

Mrs. X— , ret. 43, the mother of one child twenty-three years ago. Has 

been afflicted with endocervicitis with erosions of the os for years, for which a good deal 
of local treatment has been used. This inflammation of the cervical canal has resulted 
in thickening the body of cervix, and constriction of the external os. Has latterly had 
thickening of right Fallopian tube and some enlargement of right ovary 7 . 

Suffered from the first attack of pelvic peritonitis five yeais ago, .which came on 
two weeks after a moderate dilatation of the cervix for the relief of the constriction of 
the external os. Temperature was 103 during the cotrse of this attack, and much 
abdominal pain was suffered, particularly in the right iliac region. This attack, lasting 
four weeks ended in resolution. 

Had a second attack of pelvic peritonitis two years ago, during which the symp 
toms were less severe and temperature more moderate, but attack was more tedious 
being confined to bed six weeks and terminating in resolution, but there remained peri 
toneal thickening posteriorly and more fixation of the uterus than after the first attack 

The last attack, which resulted in abscess, was ushered in on November 12th last 
after carriage rides on two successive days, when she was nearing her menstrual period 
Had two slight chills after retiring, followed by moderate fever and some pain in back 

Moderate fever continued until afternoon of November 15th, when she was seized 
witii a very hard and long continued chill, which was followed by a temperature of 
104 1-5°. This temperature decreased in a few hours and perspiration was induced. 
Temperature was 101 1-5 ° at 3 p. m. of the 16th. The temperature ranged from 100 
to 101 for several days, accompanied by swelling and tenderness of the peritoneum 
surrounding the uterus, and fixation of uterus. As the inflammation increased the 
uterus was pushed forward and formed a tumor above the pubes. The stomach was 
very irritable, nausea coming on during sleep, which often resulted in vomiting. She 
was fed on a liquid diet exclusively. There was very little pain in the abdomen. 
Temperature did not rise above io2-£° after the 15th of November. Pus formed and 
fluctuation became apparent in the Douglas cul-de-sac and caused pain in lower part of 
the back. There was considerable enlargement of the abdomen, showing the inflam- 
mation to have extended over a large area. The accumulation of pus was so large that 
fluctuation was not distinct. 

On December 8th, while under the influence of ether, Dr. Seibert, of Easton, 
evacuated the pus by an incision made as near to the rectum as possible per vagina. 
The discharge of pus was very profuse and offensive. All went well for a few days, 
when there was a rise of temperature and other symptoms indicating that the pus was 
not having free exit. The operation was repeated on December 13th, and the incision 
was made deeper and the opening made larger, when there was another profuse dis- 
charge of offensive pus. The temperature decreased after this operation. Pus dis- 
charged freely for a long while. Began using a weak solution of carbolic acid to wash 
out cavity of abscess daily. The effect of this seemed to be very little judging from 
the amount of discharge, but she grew stronger and improved in a general way. After 
using injections of carbolized water for a month or more, began using a 25 per cent, 
solution of Marchand's Peroxide of Hydrogen. This had more influence both in re- 
ducing the amount of discharge and rendering it less offensive It was gradually used 



T 79 

stronger until it was used full strength. It was found more effective used in this way. 
The patient continued to have some fever until four months had elapsed after the 
operation, when she was allowed to be around her room some. Continued washing out 
the pus cavity once daily for nearly five months, when the discharge was so moderate 
that it was done only every second day,' when we tried to hasten the healing by the use 
of Glycozone, after first cleansing the cavity with Peroxide. The discharge became 
more profuse while using this, consequently it was given up. 

A solution of permanganate of potassium was also used for a time, but not with as 
satisfactory results as from the Peroxide. Recourse was again had to the Peroxide, and 
we began using it twice daily the latter part of May. Continued its use in full strength 
twice daily for the next two months with the result of a gradual decrease of discharge 
of pus and in the depth of pus cavity. During the latter part of July began usmg the 
injections once daily, which was continued for two months, with the result of a grad- 
ual decrease in the discharge. 

Patient suffered a relapse on August 2ist owing to over-exertion, but was con- 
valescent in ten days. \Ye have tried again to see whether an injection every second 
day will not be sufficient, but find that the discharge increases. The cavity seems 
about an inch in depth at this time and the discharge very moderate, but there are in- 
dications that it will require weeks still before the cavity will be closed. Patient's men- 
strual flow did not appear for three months after the beginning of the attack. For the 
past four months she has been able to do light housework and take short walks, and a 
few times has been in a carriage by driving on a walk. 



A PRACTICAL THEORY AND TREATMENT OF 
PULMONARY TUBERCULOSIS. 

(Abstract from the Philadelphia Medical Times and Register of January 26, 1895.) 

In a lengthy paper on the above subject, which doubtless marks a new era in the 
study of tuberculosis, Dr. Frank S. Parsons, editor of the Medical Times and Register 
of Philadelphia, Pa., has shown that pulmonary tuberculosis is primarily due to a lym- 
phatic stasis. That such stasis may be congenital or acquired. That the bacillus tuber- 
culosis is to be regarded as a development, existing simply because a favorable medium 
is presented, in the lymphatic stasis, for its cultivation. Bacilli may exert influence on 
the disease as foreign bodies, similar to other foreign or waste elements, but are not 
primarily causative. Their mere removal will not cure the disease, except as such removal 
implies restoration of perfect excrementitial function and lymphatic circulation. That 
tuberculosis implies atrophy of the pancreatic gland in the majority of cases, and the 
dislike of fats by phthisical persons is the only symptom we can depend upon to show 
that with the pancreas may lie the origin of this disease. 

In the treatment of this affection Dr. Parsons calls attention first to the catarrhal 
condition of the stomach, and considers that on the successful treatment of this condition 
lies the curability of tuberculosis; for, only by removing chronic catarrhal inflamma- 
tion of the stomach and intestines may the physician hope for proper assimilation of 
food or medicines. 

"To begin with," he says, "it will be found of advantage to insert a stomach tube 
and thoroughly wash out that organ, teaching the patient the art of performing this 
feat himself. The solution used for this lavage should be a 1 to 16 dilution of Hydro- 
zone in warm water. I prefer the Hydrozone to the Peroxide of Hydrogen for the 
following reasons: It is double the strength of the latter, its taste is not objectionable, 
and it is more active in its therapeutic qualities. The solution should remain a few 
minutes and then be syphoned out through the tube." 



i8o 

"Hydrozone acts in two ways on the mucous membrane of the stomach chronically 
inflamed; first, it clears the surface of excess of mucus, combining with the pus to form 
carbon dioxide and nascent oxygen (both gases, and easily removed through the tube) , 
second, the oxygen of the preparation acts directly and favorably in stimulating the 
mucous membrane and underlying glands, thereby favoring the circulation of the blood 
and the performance of function." 

Second to this method, for the treatment of catarrh of the stomach in tuberculosis, 
is fhe internal administration of Hydrozone before meals. A dilution of one part to 
thirty-two of water may be employed in this manner: a glassful of the mixture taken 
half an hour before meals. If the dilution is too strong the gas generated will be dis- 
tressing to the patient. On that account it will be frequently advisable to administer 
Hydrozone diluted one part to sixty-four of water. Glycozone (c. p. glycerine treated 
to .fifteen times its own volume of ozone) may be used alternately with the Hydrozone 
as a curative agent. 

Then Dr. Parsons treats of the various methods necessary to build up the body, 
the value of ozonized atmospheres and inhalations and the medicinal management of 
tuberculosis, in a practical way. Anyone not having read this article should obtain it 
from the publishers. It is now published in book form. 



THE SUCCESSFUL TREATMENT OF RIGGS' DISEASE. 

By H. E. LEWIS, M. D., of Burlington, Vt. 

Published by The Vermont Medical Monthly, January, 1895. 

A short time ago a member of my family, a gentleman of forty-five years of age, 
was suffering with what was believed to be Riggs' disease. There was no evidence of 
ulceration, no swelling and little soreneso to speak of, simply a very evident loosening 
of the right incisors, and canine in the lower jaw. 

Several dentists examined the teeth, confirmed the diagnosis, but declared that 
there was not much to be done except to await developments. 

A solution of Hydrozone was made in the proportion of one ounce of Hydrozone 
to four of distilled water, and used as a wash. 

The treatment commenced at 6:30 P. M., and the mouth was washed very thor- 
oughly three times before retiring, some of the solution being retained in the mouth 
each time for about a minute. The escape of gas showed plainly the presence of pus 
though in small quantity. 

In the morning there was a marked change; the teeth were much firmer, what sore- 
ness had been present had entirely disappeared, and the test for pus gave no reaction 
whatever. 

A weaker solution (about one to twelve) was used every four hours all day, and at 
night just twenty hours after commencing the use of the Hydrozone, the teeth w T ere as 
firm as ever and have been ever since. But in order to prevent a recurrence of the 
trouble a weak solution of Hydrozone (about one to twenty-four) is used every morning 
as a mouth wash. 

From its great antiseptic qualities it is found to be an excellent wash for cleansing 
the mouth of every bad taste, and rendering it pure and clean. 



THE PLASTER OF PARIS, WOOD, ALUMINUM, PAPER, 
LEATHER AND STEEL SPINAL SUPPORTS. 

By A. M. PHELPS, M. D., New York. 

Professor of Orthopcedic Surgery in the University of the City of New York and the 
New York Post-Graduate Medical School and Hospital; Professor of Surgery in 
the University of Vermont; Surgeon to the City Hospital; President of the 
American Orthopaedic Association. 

A discussion on Dr. L. A. Sayer's paper on the history of the plaster of Paris corsets, 
read before the Academy of Medicine at the annual meeting, January, 1895. 

(Reprint from the New England Medical Monthly for March, 1894.) 

I am exceedingly obliged for the courtesy which has been extended to me to dis- 
cuss the paper of the evening. With nearly all of the points which have been raised in 
this paper ] fully agree. And that the plaster or Paris corset, in my opinion, is one of 
the best supports for Pott's disease of the spine ever devised, my experience verifies. 
Without it, it would be difficult for me to conduct the clinics and dispensaries of which 
I now have charge. While it contains many defects and demerits, its good qualities 
will more than over-balance the bad, because of this and because its application is 
based upon accurate scientific principles I give it a most hearty endorsement. 

I have used the plaster of Paris corset from its very first inception. I have watched 
its growth from the time of its first application. I have seen it fail through bad ma- 
terials and worse application. I have seen it bitterly fought against by its opponents, 
receiving just and unjust criticisms. I have watched its methods of application gradu- 
ally re-constructed, the materials from which it is made improved, and I am free to say, 
after fourteen years of experience, that it is one of the best supports to be used in Pott's 
disease of the spine the world has ever seen. The arguments which have been urged 
against its use are most fallacious. That it does not support is argued by some of its 
bitter adversaries. But when a patient is suspended in Pott's disease of the spine, and 
a jacket properly adjusted, it is at once relieved from a condition of pain and suffering, 
and to such an extent that any amount of pressure upon the shoulders does not produce 
pain. I am convinced that something does support. If it is not the jacket, what is 
it? A patient is suspended in lateral curvature of the spine. A plaster corset with 
lacings is made to fit this suspended and straightened position. After the corset has 
been adjusted the patient is three inches taller than before its application. If the corset 
does not support, what makes him three inches taller? I have personally observed this 
change in many cases, and no amount of argument advanced by the opponents of the 
plaster of Paris corset can possibly disprove a clinical fact. One fact is worth more 
than a thousand theories. The first book written on steam navigation by an English- 
man, in which he attempted to prove that a steamship could not cross the Atlantic ocean, 
was a failure, because after his book was printed, it was brought to this country by the 
first steamship. And so it is with this argument — the patient is three inches taller with 
the corset than he is without it. What makes him three inches taller? Support. It is 
true that this corset becomes filthy; vermin invade it; but it is inexpensive, and can be 
changed, if necessary, once a month. Much better this than the application of a steel 
brace, that a mother and nurse can remove at liberty, handling the child in such a man- 
ner as to produce trauma and injury to the diseased vertebra. The steel braces must 
be frequently removed or else excoriations will occur. They excoriate and are uncom- 
fortable if they give support, which is one of the strongest arguments against their use 
in Pott's disease of the spine. 



182 

We are all agreed, I believe, that the best orthopaedic machine ever devised is the 
human hand. Guided by an intelligence, it applies forces for the correction of defor- 
mity, more delicately and perfectly than any inanimate object ever invented. Plas- 
ter of Paris is applied to the deformity. While in the plastic state the hands mould 
it to the correct position, and hold it there until hard or set. Can you not 
see that now the plaster of Paris continues to do the work exactly as the human 
hand did it ? In other words, plaster of Paris is effective as a brace of support 
only in proportion to the amount of gray celebra; matter mixed up with it. 
In the absence of. the latter it is worthless. Proper materials must be used, else 
the plaster will not set rapidly H. B. Claflin & Company make a perfect hospital 
crinoline, containing just the proper amount of sizing and no indigo. The White 
Dental Mfg. Co., of New York, puts up the plaster in tin cans, hot from the oven. 
These two materials make, when put together properly, a perfect bandage, that will set 
in five minutes. This rapid setting of the plaster is necessary, because the hand holds 
it to the corrected position of the deformity. This material, with the stockinet sold by 
Ford, completes the materials necessary to make a perfect corset. The crinoline costs 
6c. a yard, the plaster of Paris 3c. a pound, and the stockinet 30c. a yard A corset 
for a child six years old should weigh not to exceed one and one-quarter pounds, and 
for an adult two and three-quarter pounds. This makes a support as light or lighter 
than the steel brace, and it supports as the steel brace cannot. 

What the profession wants is a proper brace, one that will apply extension and 
relieve pressure, and also act as an anterior-posterior support when necessary trans- 
mitting the weight of the body through the transverse and articular processes, thereby 
relieving the bodies of the diseased vertebra, Such a support is to be found in the 
plaster of Paris corset. It removes from the nurse or the mother the possibility of inter- 
fering with the dressing. By its particularly broad, even surfaces, if properly applied, 
it does not excoriate, and can be worn for one or two years with comfort. Springing 
or bending the corset anterio-posteriorly makes it an anterio-posterior support. Thus 
we see that it combines the good qualities of all the steel braces that have ever been 
devised, and one more, and that is extension for the relief of pressure. The corset 
is heavy when improperly made It is not so porous as we are led to believe. Its 
thickness makes it objectionable t women This has led me to substitute for it the 
wooden corset, the paper corset made from paper such as is used in making- 
paper boats, and the aluminum corset. These corsets combine all of the good 
elements of the laster of Pari.- corsets, and, in addition to these., lightness, durability 
and thinness, which does not interfere with the clothing of women. 

In clin : cal work and among the poor patients the plaster of Paris corset fills the 
gap that nothing else can possibly fill. These patients, supported by steel braces, I am 
informed, and I have observed almost invariably go on from b:.d to worse as regards 
deformity. They certainly do in disease above the eighth dorsal vertebra. I feel sat- 
isfied that in this class of patients the steel brace will be utterly abandoned in the very 
near future. They certainly should be in lateral curvature ol the spine in any case. 
Now, in private practice, I know of no better dressing for Pott's disease than a light 
and thin plaster corset during the acute stage, after which the corsets that I have 
already mentioned, and which we use, will be found to be more comfortable and agree- 
able to the patients. The difficulty with leather corsets is that they fail to support, 
because they do not retain their shape — as a boot changes upon one's foot, so will a 
leather corset change upon the body. The spinal support for Pott's disease of the 
spine must be unyielding and firm. The paper corset first made by Vance is, in some 
respects, a good one; but it is not desirable; it is difficult to make and it is somewhat 
expensive. Since the time of Vance, other paper corsets have been made, according 
to different formulae, but they are made of paper, and are, really, only modifications of 
Vance's idea. The corset made by Weigel, of Rochester, N. Y., from the paper used 
by printers in making their stereotypes, he claims, is durable and comfortable. The 
corsets made for me by Horace Waters & Co., of Troy, N. Y. , after the paper boat 



i«3 

formula, have proved most satisf actor}'; but it is more bother to get them than I care 
to endure. Other corsets made in this city, similar to that made by Vance, are open to 
the same criticisms as those mentioned. The Jurymast and corset, when adjusted so 
as not to lift the head, but to draw it backwards, so as to transmit the weight of the 
head through the transverse and articular processes, makes the most efficient dressing 
that I know anything of, and particularly so in upper dorsal and cervical disease. So 
far as I have observed the deformity does not increase, as is the case with a steel ap- 
paratus, in diseases of the upper dorsal. 

Dr. Sayre has accomplished much by his constant and indefatigable hammering at 
the profession towards introducing the idea of partial suspension and fixation in Pott's 
disease of the spine, but the idea of parlial suspension and fixation in Pott's disease of 
the spine carries us back almost to the traditions of medicine. Ambrose Pare, in 
1579, used a fixation apparatus, made from steel, which is almost identical with the 
aluminum corset which I am using. 

In 1696, Von Nuck made a suspended apparatus which has been in almost con- 
stant use in Europe since that time. It is very similar to that used to-day, bearing the 
name of the distinguished author of the paper of the evening. In 1700, Heister 
devised an anterio-posterior support, which, in principle, is the same as Taylor's brace 
used to-day. It has been in use in England since that date. In 1754, Hauermann 
made a modification of Von Nuck's suspension apparatus, which seems, however, to 
be more a change of material than principle. In 1764, Levacher devised the Jurymast, 
which was attached to a corset made of steel and canvas, and was used precisely as the 
Jurymast is used to-day. Portal, in 1772, slightly modified the Jurymast, but attached 
it to a corset in the same manner. In 1825, De La Croix still further modified it by 
adding the chin piece. Heine, in 1832, still further modified Levacher's Jurymast by 
adding a chin piece and attaching it to a steel hip-band corset. These Jurymast sus- 
pensions, taken together with the description of its use, are identical with those in use 
at the present time. About the only thing that this generation can claim in regard to 
spinal supporting is in the change of materials, using the principles laid down in the 
last century and the beginning of the present. They have been in constant use since 
then, and also the principles, as exemplified here to-night. I believe them to be correct. 

I offer the aluminum corset, not as a substitute for many of the braces and corsets 
now worn in the acute forms of Pott's disease and lateral curvature; I suggest it, 
rather, to take the place of such braces in cases requiring permanent bracing, or in 
individuals who are desirous of securing a support at any time which combines dura- 
bility with lightness and comfort. So soon as a case of lateral curvature has been 
arrested, or the greatest amount of benefit has been derived from treatment, the 
aluminum corset will then be found a most agreeable, permanent support. The alumi- 
num corset has these qualities to recommend it to the patient: 

1. Lightness. 

2. Durability. 

3. It is thin and does not interfere with the form and clothing. 

4. Being extensively perforated makes it the coolest and most agreeable of supports. 

5. The patient can wear it during bathing. 

An ordinary corset weighs from one to two pounds, depending upon the size. To 
prevent cracking and to protect it from perspiration, it is covered with a waterproof 
enamel, which is applied by heat. 

The steps of its construction: Make a plaster form of the body; send this form 
to the foundry and have a cast iron anvil made; polish this, and then at a certain tem- 
perature the workmen will bend on to it two sheets of aluminum representing the two 
lateral halves. The frequent heating and hammering together with the cylindrical 
shape makes the corset almost as strong as steel. The two halves are hinged in the 
back and closed with automatic clasps in front, which stop at any notch to accommo- 
date itself to the body before and after eating. This corset completes my armamen- 
tarium in cases requiring spinal supports, viz.: 



184 

1. Plaster of Paris corsets for acute Pott's disease. 

2. The Wood corset for lateral curvature, and cured or convalescent cases of 
Pott's disease. 

3. The Beely corset for mild forms of lateral curvature, particularly in girls. 

4. The aluminum corset for permanent bracing; and, lastly, 

5. The celluloid corset, which,, in a way, takes the place of the aluminum. 

I visited Dr. Waltuck, of Odessa, Russia, in 1888, and from him personally I 
learned the details of making the Wood corset, after several days of hard work. I 
found that Professor Lorenze, of Vienna, has been using the corset for some time 
and was much pleased with it. At that time, however, many of the corsets proved 
to be inefficient on account of errors in their construction. We have used the corset 
constantly since that time, and with the modifications which we have made, it is one of 
the most efficient, comfortable and suitable braces that I know of. 

It has been with the greatest difficulty that we have succeeded in getting the proper 
materials for constructing the corset, and even nov it is cheaper and better to import 
the wood from Vienna. The spruce timber which grows there makes a better shaving 
than any timber that we have attempted to use which grows in America. It is tougher 
and works better with the glue. 

An impression is made of the body with plaster bandages. This mould is filled 
with plaster of Paris, which makes a perfect cast of the body. The corset is now 
made over this cast. The cast is changed somewhat in shape to make the form even 
straighter than the body in the suspended position. 

Corsets made according to the method followed at the time I observed the process, 
were not as perfect as they should be. The slightest excess of glue moistened by the 
perspiration of the body coming in contact with the shirt or the skin, was exceedingly 
disagreeable. The perforations in this corset weakened it, and allowed the glue to 
exude during perspiration. 

To obviate all this I had the corset perforated, in which perforations eyelets were 
punched. A special machine facilitates the perforating and the punching of the 
eyelets. The lacings are stitched on. Trim the top and bottom with kid. The entire 
corset is shellaced inside and outside with two or three coats of shellac, which render 
it impervious to moisture, the eyelets ventilating it perfectly. The improvements 
which I have made in the corset consist in shellacing it on the inside and outside and 
putting in the eyelet holes and eyelets, which add to the strength of the corset and 
ventilate it perfectly. 

An ordinary corset for an adult weighs from one to one and one-half pounds. 
They are very durable, very comfortable to wear, and thus far I believe that they are 
the best spinal braces yet devised. 

I will add, by way of parenthesis, that the corsets, when completed, can be cov- 
ered with silk or with stockinet, or they can be left in the linen finish. 

A word or two in regard to abscesses occurring in Pott's disease of the spine. 
The orthopaedist is inclined to trust them to nature, as he does in abscesses of joints. 
Pus living in contact with the diseased vertebra destroys them, and what was at first a 
small focus of disease, in a few weeks by this macerating process becomes an extensive 
disease, involving frequently the entire body of the vertebra. 

We never aspirate such abscesses. So soon as they are detected they are at once 
incised and thoroughly irrigated with a solution of bi-chloride of mercury, 1 to 2,000, 
after which they are washed thoroughly with Hydrozone until foaming ceases. They 
are then either packed with gauze saturated with iodoform, § ss, glycern, 5 iv. Small 
foci of diseases are curetted. Abscesses appearing at Poupart's ligament are incised 
and treated the same as other abscesses, only a half-inch drainage tube is passed up to 
the seat of disease on the end of a strong probe. This is the sewer through which pus 
can discharge and not burrow through the tissues. All abscesses should be opened, 
excepting when something communicates, then open them. 



i35 

RATIONAL THERAPEUTICS OF CHOLERA INFANTUM. 

By GUSTAVUS BLECH, M. D., St. Louis. 

Published by The New York Medical Journal, March 2, 1895. 

No strict rules can be given for the treatment of disease. It is for this reason 
that so many physicians say we do not treat a disease, but we treat an individual. 
True enough, we treat the individual, but what we have most of all to consider is the 
disease. The individual will dictate us alterations and modifications in our treatment. 

A general plan of treatment may be outlined, however, and I will try to do so in 
regard to oue of the most fatal diseases of babyhood — cholera infantum. 

There is a certain philosophy in therapeutics which I would frame in the three 
following rules: First, remove if possible the disturbing causes; second, treat symp- 
toms which per se are liable to endanger the life of the patient; and third, sustain 
vitality. 

As said before, the therapeutics, which is based upon the aetiology and pathology 
of a given case, is the only one to be employed. 

Now, the aetiology of cholera infantum is not so obscure as asserted by a good 
many authors. Whether or not of microbic origin, one thing is sure — it is due to a 
chemical decomposition of food, causing an inflammatory condition of the digestive and 
alimentary canal. 

Clinical experience, furthermore, shows that this disease is of a grave character, 
producing death in a large proportion. Heater se is not the immediate cause of this 
disease, but it influences its course considerably. Therefore, gastric or intestinal dis- 
turbances in summer demand a closer attention than those which occur during the 
colder season. Cholera infantum is a disease met even in the palaces of the rich, 
although not so often as in the tenement houses of the poor, which fact proves again 
that bad air, filth, and lack of ventilation are also of a predisposing influence, as well 
as an obstacle to a quick cure. The mortality in the tenement houses is larger than that 
of the richer parts. 

If we consider the aforesaid, we shall first of all, as regards the treatment of this 
disease, have to restrict diet. 

As soon as called to a case of cholera infantum, prohibit for the first day any food 
whatever. Mothers have no right to nurse the little patient either. Strict instructions 
must be given in that direction, because the timid mothers are often inclined to quiet 
the crying babies by putting them to the breast. 

Remedies iire of very little value. Beginning with calomel, salol, and all the 
newer antiseptics, finishing with subnitrate of bismuth — they have all proved a failure, 
for none of them work quickly enough. 

The treatment as outlined by Dr. Elmer- Lee, of Chicago, in his cases of typhoid 
fever, proved a success in my hands during last summer, and under this treatment I 
have lost only one patient out of twenty-three, while the monuments of my skill exer- 
cised during the year 1893 are decorating the cemeteries of the State of Connecticut. 

So far as I knew, the best antiseptic (which has also a strong tendency to reduce 
local inflammation) was peroxide of hydrogen (medicinal) until hydrozone was used by 
me. Hydrozone being twice as strong as Marchand's peroxide of hydrogen (for eco- 
nomical reasons), the latter drug is preferred by me. This remedy can be adminis- 
tered internally as well as externally. 

I add a tablespoonful of hydrozone to a pint of water for washing out the stomach. 
The vomiting ceases after the first washing as a rule. If necessary, this procedure can 
be repeated. If the vital power of the little patient is not too low it can produce no 
harm. But in every case, no matter how far advanced, I do not omit an irrigation of 
the bowels, for which purpose I use a soft rubber catheter attached to a common bulb 
syringe. The catheter is introduced as high in the colon as possible. It is unneces- 



1 86 

sary to say that the water must first be sterilized. I do not agree with Dr. Lee in 
using hot soap water. On the contrary, I use cold water, and add to each quart about 
two ounces of hydrozone. The improvement after the first or second irrigation is 
marked. If necessary, these irrigations can be repeated every two hours. 

Among other remedies there are only two to be employed, morphine and strych- 
nine. Both ought to be administered hypodermically. Their indication is too well 
known and they are about all we need. No antipyretics should be given. If the fever 
is very high and if the irrigation of the bowels does not reduce it, the whole body 
should be washed with alcohol. 

The diet for the next twenty- four hours should be very light indeed. Sweet, 
strong Russian tea is all I allow. 

Each individual case will teach us when food can be allowed again. 

Since the adoption of this mode of treatment I have met with the most remarkable 
success, and no honest practitioner should refuse it a trial. 

ii N. Broadway. 



A GLANCE AT THE MANAGEMENT OF CAPILLARY 

BRONCHITIS IN INFANTS. 

By DOUGLAS H. STEWART, M. 1).. Nkw York. 
Physician to Harlem Dispensary. 

Published by Times and Register \ of Philadelphia, Pa., P'eb. 17, 1894. 

The treatment has for many yean; been emetics, ammon. carbonat. and ammon. 
chlor. Of the emetics, syrup of ipecac is time-honored, and deservedly so; but have 
you never ordered this valuable remedy and on returning found your patient worse, and 
not a sign of vomiting ? My experience of this preparation as made or kept in the 
average apothecary shop is far from comforting, one-half a teaspoonful of one sample, 
acting as an emetic, while a teaspoonful of another only made the little child nauseated 
and depressed. 

It has seemed wise to me not to tell the nurse what I was giving at all, but to order 
syr. ipecac, two ounces, a teaspoonful to be given every twenty minutes until vomiting 
or purging, then stop; and I have generally gone back to smiling faces, instead of sol- 
emn remarks about the medicine not acting. Whatever is given in excess of the re- 
quirements will be either vomited or purged. 

Children under three yeais of age do not expectorate, but we often notice quite an 
amount of mucus or muco-pus unloaded from the bowels. The mother will often make 
an anxious complaint that the child does not "raise anything," but a prompt statement 
that little children never do, and an exhibition of the slimy passages contained in the 
diaper, will go far to reassure her both as to her fears and your knowledge of the case. 

The ammonium compounds I have discarded — as the only real effect I could ever 
find from them in the acute stage was that they made my patient sick "at the stomach." 
Of course, I am a heretic, and deserve boiling in oil for such a statement, when all the 
prominent physicians of the early part of this century set the seal of approval on the 
chloride and carbonate — still, this is a clinical paper, and I can only give the results of 
experience, and not of a diffusible, stimulant, expectorant theory, and, after using them 
till you have lost many cases, face about and give one teaspoonful every hour of the liq. 
potassa citratis or mist. pot. citratis — a simple refrigerant diuretic — agreeable to child, 
lowering the temperature and having a most soothing effect on any acute inflammation. 



i8 7 

Let the expectorants alone. They only increase the activity and congestion of the 
mucous membrane. 

Externally, if the patient is strong, flaxseed poultices; if weak, no poulticing at all 
— but turpentine "liniment" rubbed in thoroughly every three hours, from the chin to 
the pubes in front and from neck to coccyx behind. 

My patients have all their clothing removed; the bandage generally worn since 
birth, especially. Have the abdomen free — this is the first commandment. Then a 
loose cotton or muslin night gown put on, and over this a blanket — all very loose — 
pinned at the neck and down the front, if necessary, with large safety pins. Don't put 
the patient next the blanket; some skins will not stand wool next them. 

The sick room should be kept at seventy-five degrees — a thermometer is indispen- 
sable. On a stove, or over an alcohol flame, boiling water, and into the kettle a tea- 
spoonful of turpentine poured on the steaming water every hour, so that the case is con- 
stantly in an atmosphere of steam and the steam carries minute particles of turpentine. 

Should a case prove a bad one, or not making the progress I could wish, the 
blanket is opened and handkerchiefs wet with dilute alcohol or whisky, are spread over 
the chest and abdomen every fifteen minutes. 

The parents will not permit cold water packing, because they fear the child will 
"take cold." Alcohol or whisky is quite a different thing in their eyes from water, and 
they know that heat destroys the strength and virtue of spirits, and they approve of 
spirits, externally at least, if not in every other way; therefore they will usually gladly 
second cold liquor compresses. 

Keep up the packing until you find a very decided improvement — as you will if it is 
not too late. An improvement in breathing, in cyanosis and dyspnea, and a fall of from 
one-half to one degree in rectal temperature. 

Then rub the child well with dry towels and replace blanket and gown. 

Should any signs of collapse appear, dry heat or a hot bag will offset them. 

The alcohol or whisky acts in four ways. First, some is absorbed by skin, and 
breathed in as a vapor. This stimulates. Second, the reaction from the cold brings 
the blood to the surface and away from the lungs. This relieves congestion. Third, 
the cold stimulates the heart and makes the patient take deeper inspirations. Fourth, 
it lowers the temperatuie. 

After this I give from ten to twenty minims hourly of peroxide of hydrogen in the 
following non-oxidizable mixture: * 

R Marchand's sol. Hydrogen Peroxide, 3 v-x according to age. 

Glycerine \ j . 

Aq. q. s. ad. § iv. 
M. Sig. One teaspoonful every hour as directed. 

This is supposed to supply some of the lacking oxygen to the blood and it does 
seem, from its effect, as if the stomach did take it up. 

It will be noticed that I have written "Marchand's Solution" — well, if your have 
used any other kind for this purpose, I am sure you don't need my arguments to con- 
vince you that you were disappointed. Also please remark that there is nothing to 
spoil the peroxide in the above mixture. 

In conclusion watch the urine carefully, especially look out for suppression. You 
will scarcely find it when giving potassium citratis — otherwise you may, and when you 
relieve the suppressed urine you will often relieve the dyspnea. 



* A mixture of glycerine with Peroxide of Hydrogen will not keep for more than three days. Con- 
sequently, it must be made fresh every three days. 

See article headed "The Therapeutics of Glvcozone" by Dr. Cyrus Edson, page it. 



After the fever is nearly or quite gone and the cough only is left, I generally start 
my expectorants, and have found the following commonplace mixture served me well — 
combined with our standby oleum morrhuae emulsion q. s. ad. lib. 
I£ Ammon. Carb., gr. xx. 
Vin, Ipecac, 3 j, 
Syr. Senegas, 3 iv. 
Glycerini. 3 iv. 
Vini Xerici, 3 iv. 
Syr. Tolu, § j. 
Aq., q. s. ad., § iv. 
M. Sig. A teaspoonful every two or three hours until cough* is relieved. 
1$ Syr. Hypophos. Co., § ij. 
Syr. Calc. Lactophos., § ij. 
M. Sig. A teaspoonful four times a day until relieved. 



NOTES ON THE TREATMENT OF DIPHTHERIA. 

Read before the Orleans Parish Medical Society, January 13, 1894. 

By. ARTHUR WEBER, M. D., New Orleans, La. 

(Reprinted from the New Orleans Medical and Surgical Journal, February. 1894.) 

This brief report of the following eighteen cases of diphtheria may be of some 
interest on account of the treatment adopted in each being almost identical. The 
majority of them occurred in poor and ignorant families whose sanitary surroundings 
were abominable. A few of the parents were hardly endowed with sufficient intel- 
ligence to properly carry out the instructions of the attending physician. These cases 
were the longest under treatment. 

Having had a belief that diphtheria was a local disease, with constitutional symp- 
toms produced by the absorption of toxic material, it has been my aim to combat it at 
the point of infection, and by destroying the nest of the bacilli to remove the source of 
the poison. 

This theory has, to my mind, been proven in the success attending these cases. 
For as soon as there was an improvement in the local development of the disease there 
was a corresponding improvement of constitutional symptoms. By this I do not mean 
to say that we should depend entirely on local treatment, for no cases ever come under 
our care where the effect of the absorption of the poisonous tox-albumen is not notice- 
able, and it is necessary to adopt some general plan of treatment to destroy the effect 
of this effete material in the blood. 

The following is the treatment adhered to in all cases coming under my attention. 
The throat is sprayed every twenty minutes during the day and every hour at night 
with pure Peroxide of Hydrogen (Marchand's) until the membrane has disappeared. 
After the removal of the membrane has taken place the spray is continued every two or 
three hours for several days, when the patient is discharged. "Whenever the pure per- 
oxide causes too great irritation of the throat it should be diluted with water and slightly 
alkalinized. One to three is about the weakest solution I have found useful. 

At each sitting it is necessary that the parts involved should be well attended to; 
never introduce the nozzle only two or three times, but continue it for a minute or two, 
permitting the child to breathe after each application. Under such treatment you will 
be gratified to find the membrane dissolve, and often come off in pieces. 

For systematic treatment at the commencement one-twentieth grain doses of calo- 
mel, combined with a strain of bicarbonate of soda, is given until there is an increase in 



the salivary secretion and production of four or five characteristic calomel stools, which 
usually takes place in twenty-four to forty-eight hours. The following- prescription, a 
teaspoonful every two or three hours, is given after the action of the calomel. 
1$ Tinct. ferri chloride, 3 iss. 
Glycerine. 3 iv. 
Aq.,§ij. 
If at any time during the attack there is any indication of heart failure, very small 
doses of strychnia and digitalis are given. 

For food, brandy, milk, milk toddies, egg-nog, white of egg beaten up in water, 
the juice of meat broiled very rare, cocoa and Ducro's elixir are ordered at regular inter- 
vals. 

The results of the above treatment can be seen in the following eighteen cases: 

1. Ada W., 3 years; membrane disappeared in five days; under treatment twelve 
days; recovered, 

2. Edna D., 2 years; recovered in twenty days; membrane disappeared on fifth 
and reappeared on the eighth day. Slight paralysis. 

3. Ralph E. D., 2 years; recovered; membrane lasted seven days. 

4 and 5. Mrs. R. E. D., and baby, recovered; membrane three days. 

6. Annie E. YV., 6 years; recovered nineteen days; membrane in throat and nose; 
a very severe case; followed by paralysis of palate. 

7. Man' W., 9 years; recovered in twenty days; membrane twelve days; paralysis 
of palate. 

8. Tillie M., 10 years; died on the ninth day; there was sloughing of the palate. 
The child was given a glass of cold beer and died thirty minutes after. 

9. Alfred M., 3 years; recovered twenty-five days. 

10. Henry M., I year; recovered twenty-two days. 

11= Bertha W., 8 years; recovered twelve days, paralysis of palate 

12. Baby W., 1 year; recovered six days. 

13. William W., 3 years; recovered twelve days; membrane seven days. 

14. Thomas W., 5 years; recovered fourteen days; membrane six days. 

15. Lizzie S., 7 years; recovered ten days; membrane four days. 

16. Louis M., 6 years; recovered thirty-two days; thrice the membrane disappeared; 
paralysis of palate. 

17. Daniel R., 5 years; recovered seventeen days. 

18. Charles FL, 3 years; recovered eight days. 

In none of the patients, with the exception of case 8th, did the temperature rise 
above 103' nor last longer than five days. In case 8th the temperature rose to 106°. 
There was gangrene of the throat at the first visit; sloughing of the uvula and parts of 
the palate occurred on the fourth day. 

Cases 7th, 8th, 9th, 10th, nth and 13th were covered with a diffuse erythema, 
which I at once thought was measles. 



SCARLET FEVER. 

By A. G. CALDWELL, M. D., of Ballardville, Ky. 

('Published by the Louisville Medical Monthly, May, 1895.) 

During the spring and summer of 1894, I treated twenty-nine cases of scarlet fever, 
without a death or a serious sequela. These cases ranged in severity from mild to 
malignant. 

Treatment: For the mild cases 1 gave a simple fever mixture; kept the bowels and 
kidneys active and anointed the entire body with "sweet oil," three times a day, to 



190 

allay itching, and to prevent drying up and diffusion of scales. Kept patient on a light 
diet. 

When the fever arose above 103° I put patient in bath of temperature ioo°, and 
gradually reduced water to 75 . This promptly brought down the fever, quieted ner- 
vous symptoms, and refreshing sleep followed; anointed the entire body three times a 
day with carbolized sweet oil; this allays the intense itching, prevents scales from drying 
up, and reduces the danger of contagion to a great extent; gave whiskey and strychnia 
to support the heart; cascara sagrada to keep the bowels open; infusion of digitalis 
leaves and acetate of potash to keep kidneys active and prevent nephritis. Kept the 
patient on exclusive milk diet, and during convalescence gaveelix. gentian and tincture 
chloride iron. For throat and nasal passages, sprayed three times a day with Peroxide 
of Hydrogen (Marchand's). 



CHOLERA INFANTUM. 

By I. N. LOVE, M. ])., St. Louis. 

(Published by The Medical Mirror, June, 1895.) 

It is well for us to remember that every case of cholera infantum has prior to the 
initiation of serious and dangerous symptoms, a history of one or more days of general 
indigestion, manifested by diarrhoea and sometimes occasional vomiting. We should 
emphasize in the most positive way upon the minds of mothers the importance of giving 
attention to these primary deviations from good digestion to the babe. After the 
advanced state or definite state of cholera infantum has arrived, the conditions are des- 
perate and often but little can be done. 

To be brief, the best way to cure cholera infantum is to prevent it or check it in 
the first stage. Given an artificially fed child with a considerable degree of summer 
heat and the chances of fermentative changes occurring in utensils for feeding or the 
food supply, we have the conditions favorable to the development of cholera infantum. 
If the child be teething, its nervous system on edge, as it were, all sorts of reflex dis- 
turbances present in consequence, the conditions are doubly favorable for the disease. 

It goes without saying that the gums cannot safely be ignored. While we have 
escaped from the old time slavish thought that every deviation from health in the teeth- 
ing child was due to the teething yet we should not go to the extreme of ignoring the 
thought which is the correct one that an erupting tooth renders the child more susceptible 
to all kinds and conditions of disease, particularly those connected with the digestive tract. 
The condition of the tongue as expressive of the state of the stomach should be grasped. 

Every evacuation from the bowels should be carefully scrutinized with a view to the 
determining of the condition of the alimentary canal. 

All the newer remedies may pass before us in review but we can find among them 
none that will equal the old time calomel in very small doses. Prolonged trituration of 
calomel unquestionably emphasizes its effect. The twentieth of a grain together with 
one grain of the bicarbonate of soda, is usually sufficient, and this should be given as 
often as once in two hours on the first appearance of indigestion whether diarrhoea be 
present or not. Frequent vomiting with marked evidence of a fermentative stomach can 
be relieved more promptly by washing out of the same than in any other way. The use 
of a large size male catheter attached to a fountain syringe, using a pint of water prefer- 
ably at the temperature of the body, to which has been added four tablespoon fuls of 
hydrozone. I have repeatedly found after this procedure nothing further required to 
calm the riotous stomach. A diarrhoea accompanied by much tenesmus, great fre- 
quency in evacuation, small unsatisfactory stools mingled with mucus and blood can 
be relieved in a very satisfactory manner by the flushing out of the bowel. The large 



1 9 I 

size, soft rubber catheter referred to above, is ample. A pint to a piut and a half of 
water, the temperature dependent upon the temperature of the child. If there be a very 
pronounced fever present, cool water may be very satisfactorily used. I find a pint to 
a pint and a half usually sufficient and add thereto about two ounces or four table 
spoonfuls of hydrozone. 

It is my custom to introduce the catheter about two-thirds of its length into the 
bowel and in this connection permit me to suggest that every household syringe should 
have accompanying it a large soft rubber male catheter for use in the enema. The hard 
rubber nozzle on the end of the average syringe is harsh and unsatisfactory. It does 
not reach in many instances, on account of the timidity of the mother and the difficutly 
of its introduction, beyond the sphincter and this accounts for the frequent failures in 
giving injections into the bowels. The soft rubber catheter referred to, can be intro- 
duced much more readily, can do no harm and from its length the fluid can be intro- 
duced high up in a manner to give satisfaction. The injections described above, of pure 
water (and I prefer distilled water for this purpose whether washing out the bowels or 
the stomach. The Crystal Water Co., of St. Louis, furnishes a double distilled water 
which is now in general use in this city and this is especially acceptable) with the addi- 
tion of one or two ounces of Hydrozone to each pint, I have repeatedly found after such 
washing out of the bowel a complete rest from frequently repeated or Straining actions, 
the patient often going the entire night without being disturbed by a movement from 
the bowels. 



ACUTE GLOSSITIS. 
By MORTIMER H. BROWN, M. D., Holcomb, III. 
(Published by The Alkaloidal Clinic, of Chicago, 111. July, 1895.) 

May 26th I was called to see W. B., German, aged 50 — worker among sheep — 
with the following history: General health good except that last winter he had several 
boils; does not drink or use tobacco to any extent. On the 24th day of May he noticed 
a small pimple on the left side of his tongue; on the 25th he had a violent headache, a 
profuse sweat and pain and dryness in the throat and tongue — pimple slightly larger 
and painful. Towards evening he placed a small piece of alum on his tongue and went 
to bed. In the morning, the 26th, his wife noticed that he could not speak and that his 
tongue was greatly swollen and protruded from his mouth interfering with res- 
piration. 

I was at once summoned and found his tongue filling his mouth and protruding 
about two inches out of it, of a dark purple color, very offensive odor, glands about the 
jaw and neck swollen, and his temperature 104, with profuse sweats and chills. As the 
dyspnea was increasing rapidly, I at once made a free incision into the tongue and let 
out about six ounces of very dark blood, and started the following treatment: Ice bags 
to neck and throat, pieces of ice on tongue and a spray of Marchand's Peroxide of Hydro- 
gen medicinal every half hour, with veratrine for the fever. At my evening visit the tongue 
was about the same, temperature 102, sweats and chills worse. 1 thought, after obtain- 
ing the above history, that there was probably infection from the sheep and so adopted 
means to prevent general septicemia from absorption, giving calcium sulphide in full 
doses with tincture of chloride of iron — ten drops in a teaspoonful of glycerine every 
four hours — with alcohol baths and veratrine for the fever. On the 27th there was 
marked improvement; tongue was less swollen, temperature 99, glands not so large and 
he could speak some. He complained of the left side of the tongue; had an ulcer on it 
the size of a bean. I scraped it and dressed it antiseptically every half hour. On the 
following day his temperature was 103, with some sweats and chills and same headache 



192 

with diarrhea, but the next day the above symptoms had left him and he was better in 
all respects. On the 30th improvement still continued. The ulcer was healing, the 
glands were not so large but still very tender. Up to this time he was fed through a 
rubber catheter attached to a funnel, but on the following day he could take food 
naturally. The tongue rapidly returned to its natural size, the ulcer granulated over, 
the glands increased in size and the tenderness was relieved by a fifty per cent, iodine 
cerate with iodide of lime internally, and on June 4th he was discharged. 

What do you think caused the rapid swelling of the tongue? Was it the alum or 
is there a disease among sheep of that nature? He has worked among from ten to fifteen 
thousand sheep annually for several years. I think the calcium sulphide prevented 
general suppuration as he was on a fair road to septicemia. 



POISON IVY. 

By R. M. CLARK, M. I)., of Ada, Ottawa Co., Kas. 
(Published by the Medical A rena, of Kansas City, Mo., August, 1895). 

A boy, ■ Woods, set. 12 years, had been fishing along the banks of 

a small stream in May, and became severely poisoned about the head and face. When 
brought to me for treatment, a couple of days later, the case presented the following 
symptoms. 

Head and face covered with large vesicles which broke and oozed a water)- and, in 
some places, as around the eyes and ears, a yellowish muco-purulent substance. The 
left side of the head and face had been the worst poisoned and the eye of that side was 
swollen completely shut and highly inflamed. The nose discharged a yellow, offensive 
matter and the pain and itching about the head and face was intense. In her anxiety 
to relieve the boy's suffering the mother had made an application of moist baking 
soda, which, from its strong caustic properties of course, only increased the itching and 
aggravated the matter. 

I had in previous years treated other members of this family and knew them to be 
highly susceptible to the influence of poison ivy (rhus radicans) so much so that one be- 
came poisoned a distance of 200 feet, while passing timber in the spring, with the wind 
blowing from the woods. On learning this circumstance I had cautioned the parents 
and warned them not to allow their children around the woods, especially in spring time, 
when the sap flows most freely in the vine and the poison is easiest of communication. 
The caution had not been heeded. 

Treatment: I bathed the face with Marchand's medicinal Peroxide of Hydrogen dil- 
uted with three parts of warm water, until the itching had almost subsided and the alka- 
line application was thoroughly removed; thenl carefully sprayed the nostrils, removing 
considerable yellowish, offensive matter and instilled a few drops of atropine in the 
congested eye. I gave the mother a half-pound bottle of the medicinal peroxide 
(Marchand's) with instructions to bathe her boy's head and face every hour with a solu- 
tion prepared three parts of warm water to one part II 2 O s (medicinal) and internally 
I ordered given every hour, five or six drops of sanguinaria 3x. The result was a com- 
plete cure in two days. 

I am of the opinion that the small percentage of acid necessary to prevent decom- 
posure of the hydrogen peroxide (Marchand) was sufficient to neutralize the caustic 
effects of the alkaline application and materially aided in the cure. 



i93 ' 
TREATMENT OF ASIATIC CHOLERA. 

By ELMER LEE, A. M., M. D., Ph. B., Chicago, III. 

Read in the Section on Practice of Medicine, at the Forty-sixth Annual Meeting of the 
American Medical Association, at Baltimore, Md., May 7-10, 1895. 

(Reprinted from the Journal of 'the American Medical Association, June 22, 1895.) 

Spasmodic cholera — called also malignant, epidemic, Asiatic, Indian, blue, and 
pestilential cholera — is generally epidemic, though not contagious. The first symptoms 
are generally experienced during the night, sometimes beginning with a light general 
uneasiness and moderate diarrhea; at other times the symptoms come on violently and 
follow each other rapidly. In fatal cases death usually occurs at some period be- 
tween six and twenty -four hours; in a few fatal cases the patient lingers two or three 
days. The ordinary course of symptoms are more or less diarrhea; the discharges at 
first feculent, but soon presenting the appearance of rice-water or gruel; there are flying 
pains, or sense of coldness in the abdomen, as if purgative medicine were about to 
operate; the countenance is pale; there is nausea, vomiting, prostration of muscular 
power and nervous agitation; cramps in the legs, arms, loins and abdominal muscles, 
more or less severe; small, weak pulse, intense thirst, and urgent desirefor cold water; 
in most cases cold, clammy skin; all these symptoms may appear successively or almost 
simultaneously. In some cases the premonitory symptoms exist for eight or ten days; 
and sometimes the patient is prostrated at once. When the disease comes on suddenly 
the cramps usually begin in the fingers and toes, rapidly extending to the trunk; the 
eyes are sunken and surrounded by a dark circle; there is vomiting and purging of 
white matters mixed with flocculi; the features are sharp and contracted; the expres- 
sion of the countenance wild and confused. The face, extremities, and often the whole 
surface of the body manifest a varying intensity of a leaden, bluish or purplish hue; the 
extremities sunken, the nails blue, the pulse thready or wholly imperceptible at the 
wrist, arm, axilla, temple or neck; there is great restlessness, incessant jactitation, 
severe pain in the epigastrium, loud moaning or groaning, difficult and oppressed 
breathing; difficult inspiration, with short and convulsive expiration; voice hoarse, 
whispering, or nearly suppressed and plaintive; the tongue is white, cold and flabby, 
and the external temperature often sinks below 80 degrees; convulsions recur at short 
intervals, or a constant tremor exists; The secretions of bile, saliva, tears and urine 
are entirely suppressed, and a cadaverous odor exhales from the body. The patient 
retains his faculties to the last. 

Some of the symptoms may be disproportionately severe, or may be entirely absent. 
Those usually regarded as pathognomonic are: watery dejections, blue appearance of 
the countenance of surface, thirst, coldness of the tongue, and pulselessness at the wrist. 

The foregoing description of the symptoms of cholera is indicative of the nature of 
the disease calling for human aid. The time in which to treat the patient sick with 
cholera is exceedingly limited. What is to be done must be executed with rapidity. 
There is not a moment to lose between the time when the patient is first seen and the 
accomplishment of severely practical efforts. Many wise theories may be promulgated, 
but there are few practical measures that will avail against Asiatic cholera. The ex- 
periences during the cholera epidemic of 1892 in Europe, both in Russia and Germany, 
produced in me a profound conviction that, for the most part, remedial agencies that 
have been used are of questionable utility. Nearly every prominent remedy proposed 
and tried has been found to end in greater or less disappointment. Years ago, great 
reliance was placed upon the far-famed "mild chlorid of mercury." Twenty and ten 
years ago this remedy was given in large doses. Three years ago, during the latest 
epidemic, small doses prevailed. Next to this, the synthetic drug salol, the product of 
the laboratory of the Imperial Institute of Experimental Medicine in St. Petersburg, 



194 

was the most widely used and the most favorably received. Professor Nenski, the 
originator of salol, personally informed me that the value of the drug could not be seri- 
ously recommended as of much importance, but that it perhaps answered the require- 
ments as far as any drug could answer, in the hands of his colleagues. Widely 
circulated and various reports, enthusiastically commending and moderately commend- 
ing this remedy were received by the Professor in St. Petersburg, but he himself was 
silent as to its efficacy. The far-famed and seemingly unmatched drug, quinin, has 
been used, and has been held as a dazzling gem before the eyes of the profession by 
some of our best men, who believe that cholera is analogous to malarial disorders, and 
consequently the medicine which occupies the position of keystone in the arch, for ma- 
larial treatment, is a remedy suitable to contend with the rapid and desperate symptoms 
of Asiatic cholera. Quinin has a stout advocate in our own country, in the person of a 
well-known professor in one of the Ohio medical colleges. It was not used, to my 
knowledge, in the treatment of cholera during the last epidemic in Europe. 

A remedy was brought to Hamburg during the latter part of the epidemic of 1892 
by the representative of an English syndicate, who posed as a chemist, not a physician. 
His remedy was a preparation of iodin, to be administered through the mouth. He 
called the medicine a periodate, and made some experiments upon patients in one of the 
cholera hospitals in Hamburg. His remedy, however, was not favorably entertained 
by the medical authorities in charge of the cholera patients, and whatever claims were 
reported came through the interest of a friendly correspondent of one of the Hamburg 
weekly secular papers. To show how misleading some of Our supposedly authentic infor- 
mation often is, it is only necessary for me to refer to the report given in the "Year Book 
of Medical Progress," published in Philadelphia. Of all the progress made, of all the 
combined investigations during the entire epidemic of cholera throughout Europe in 
1892, and there was an immense amount of original investigation and great effort made 
to discover a remedy, the curious spectacle in the Year Book, which alone refers to the 
remedies brought by an agent of a syndicate from London to Hamburg, at the closing 
of the epidemic of cholera, shows that there are some things in our profoundest medi- 
cal publications that are to be taken cum grano sails. Uretin was extensively used 
hypodermically for its alleged influence upon the secretions of the kidneys, upon the 
ground that the kidneys were to be aided by irritating them to greater functional activity 
to eliminate morbid elements through the urine. The result of many investigations 
recorded in Russian practice show that this drug is not to be commended. Digitalis 
was used, supposedly to benefit a weak heart. This remedy, if at all useful, could be 
little more than palliative. The use of acidulated water was extensively employed in 
different hospitals in Europe as a drink, but not prescribed as a remedy. The water 
was acidulated with HC1 and H 2 S0 4 . Subcutaneous injections of salt water were 
made. The proportion of salt was one-half of I per cent., and the amount of saltwater 
injected subcutaneously was sometimes as much as a quart at a single injection. In one 
instance, during an illness of several days, as much as thirteen quarts were subcutaneously 
injected into the cellular tissue, principally "that of the abdominal wall. This process 
of subcutaneous injection was known as hypodermaclysis. The purpose of the hypo- 
dermaclysis was to maintain the volume of the blood. The diminished volume of the 
blood is directly the result of the waste of its liquid portion or serum into the alimentary 
canal. In this serous discharge, flakes of intestinal mucous gave the name of "rice-water 
discharges" to the bowel evacuations, the particles having a resemblance to grains of rice. 
The general inflammatory state of the intestinal mucous membrane, throughout its en- 
tirety, drains the blood of its liquid portion rapidly, and collapse due to stagnation of 
circulation quickly ensues. 

The remedies mentioned are only a portion of those tried; but there is no living 
advocate who to-day can point with unerring certainty to one single organic or inorganic 
substance, howsoever administered, that can be safely depended upon in the treatment 
of Asiatic cholera. Both botany and mineralogy have been searched in vain fo,r a cure 
for this disease. 



195 

The cause of this disease is perhaps accurately stated to be due to invasion of the 
blood and, secondarily, of all the tissues of the living organism, by toxines or ptomaines, 
which originate in the upper portion of the small intestine at the early stages of cholera. 
These products of organic activity, whether of animal or vegetable organisms it is here 
unnecessary to debate; but these noxious products enter the circulation through the 
villi of the intestine and rapidly and desperately poison the blood. It is clearly proved 
that the disease is the result of general blood poisoning from an intestinal origin. 
Whatever the chemic nature of the poison may ultimately be found to be, maybe safely 
left to the bacteriological laboratory. The practical and intensely important part that 
remains for physicians seeking to cure patients in times of this disease is to realize how 
much, as well as how little, it is within human power to do. The human organism is 
prostrated by a fierce and deadly poison. This poison is in the blood and in the cells 
of the tissues, and its work of destruction is quickly and effectually accomplished. Re- 
flectively, to say nothing of experimental research, it would seem to me that the rational 
and only course that could be advocated with scientific assurance of relief is to, as far as 
possible, literally cause to be removed these products which are death-dealing to the 
body in which they happen to be found. Now in the same reflective mood, think for a 
moment and try with me to determine whether it is possible in such conditions as pro- 
duce the symptoms of Asiatic cholera, it is safer to introduce other poisonous products 
to neutralize the noxious elements in the blood and cells, or whether it is a better pro- 
cess to, without the introduction of additional foreign substances, remove what we 
already find in the blood. To make this proposition clearer, it could be stated in an- 
other way, namely, the body is already bearing a crushing burden; shall we add other 
foreign substances as an additional burden to the load already carried? The principle 
seems to me to be at fault. The principle is the principle of allopathy, but in the light 
of facts is it a safe principle to follow ? It is reasonably scientific to produce in the 
laboratory, definite results in vessels of glass by the use of fixed reagents; in the organic 
laboratory of the living body, no such definite results can be demonstrated. The vital 
principle is an entity which enters into the formula and may be represented by the un- 
known quantity x in algebraic equations. Great and laudable efforts have been made 
to prevent as well as to cure this disease by inoculation. 

Ferran, of Valencia, Spain, thrilled the world ten years ago with his proposition of 
a universal cure for this disease. His glory was then at its zenith. His fame has long 
since faded. So obnoxious became his proposition to the government of Spain that laws 
were adopted to suppress Ferran's cholera inoculations. 

A worthy colleague and laborious investigator, Professor Haffkin, of Pasteur Lab- 
oratory fame, proposed a modified inoculation for the prevention and cure of cholera in 
1892. A reporter of the New York Herald was inoculated at the Pasteur Institute, and 
with credentials sent to expose himself to Asiatic cholera at Hamburg in September, 
1892. The same reporter had been similarly inoculated by Ferran in 18 86 and had the 
courage to make further exploits in behalf of his newspaper, at Hamburg. A very 
widespread opinion prevails in America that the exploit of the New York y Herald reporter 
during the ten days' stay as a nurse in the Hamburg hospital, constitutes a proof of the 
validity of Haffkin's claim, but the scientific world of Europe knows differently. En 
passant, it may be interesting to state at this place that further experiments have been 
made by Professor Haffkin in India with the cholera inoculations and, unfortunately for 
the proposition, reports have recently come to me from reliable medical sources, that a 
greater percentage are attacked with cholera who have been previously inoculated than 
of those who have not been inoculated. This subject of prevention, however, is to be 
discussed by me in a paper to be read before the Section on State Medicine. 

The result of prolonged recollection, covering many years, and the observations 
resulting from personal experience in the cholera epidemic in Europe of 1892, is the con- 
viction that there is provided in the laboratory of the universe a remedy which surpasses the 
results of human ingenuity as much as does the sun surpass in brilliancy the light of the 
artificial lamp. The all-prevailing and all-wide remedy, the greatest product of omnis- 



196 

cient nature's laboratory, which alone can cope with this pestilential disease of the human 
race, is nothing more and nothing less than the unmatched, unmatchable H2 O. Pure 
water is absolutely the only trustworthy cure for cholera, and if it came at a great price it 
would probably be more greatly valued. The human organism is so constituted that if 
it is assisted by H2 O, every morbid element may be eliminated- out of its domain. 
The acutely poisoned body quickly recovers its equilibrium and its harmony of action as 
soon as the processes of elimination can remove the invading poison. In the construc- 
tion of the mucous lining of all the accessible cavities and channels it is prepared by an 
undiscernable law to successfully resist the entrance of every form of organism. The 
products of organic action alone are able to pass into the blood. If sufficient quantities 
of pure water, of a suitable temperature, are introduced into the body through the 
natural channels, it is actually possible to wash morbid products as well as organic 
forms of life, out of the human body. The mouth gives entrance to the causative germs 
in Asiatic cholera. This is quite conclusively established. The locality of the develop- 
ment and formation of the toxin in the earlier stages is determined to be in the upper 
end of the small intestine; and from experience, as well as from the powers of reflec- 
tive analogy, there is no doubt that the system can be saved from death if the morbid 
entity, the germ, is literally deluged away from the alimentary canal by the copious use 
of a remedy that cannot be of the slightest danger to the victim. The amount of water 
to be used varies in different cases. It is impossible to use too much; it is possible to 
use too little. From the earliest moment that the patient is seen, the propositions 
should be, first, wash the whole alimentary canal with pure water; wash the lower por- 
tion by introducing irrigations of warm soapsuds or merely warm water into the colon 
sufficiently frequent and sufficient in quantity to cleanse that portion of the bowel 
effectually. The frequency of washing that portion of the bowel which is accessible from 
the rectum should be one, or two, or three, or four times a day, according to circum- 
stances. At the same time from one to ten quarts of warm pure water mildly medicated 
with Peroxide of Plydrogen or Hydrozone should be administered at regular intervals, 
during the day, as the prescribed remedy by the mouth. If the patient vomits, very 
well. Immediately re-introduce the quantity of water that was vomited. No harm can 
be done in any case, and if it is possible to save life it is possible to save it through this 
method. It is the quickest and surest method of exciting the activity of the kidneys, 
and it is the safest. It is the rational and effective measure for maintaining the 
volume of the blood. It is the scientific process by which to establish cutaneous circu- 
lation in the capillaries. 

The use of simple and useful hygienic measures are the same as in other prostrat- 
ing diseases. Patients should be fed with regularity at not too frequent intervals, giving 
the proper time, between administrations of simple food, for its digestion. The use 
of appliances for maintaining the heat of the body are not to be neglected. 

The precise details of the method of treatment indicated at this time will be forth- 
coming in a subsequent paper. 



WATERY ULCER. 

By M. F. Richards, M. D., of Toledo, O. 
(Abstract from the Homoeopathic News, of St. Louis, Mo.) 
Editor Hojna:pathic News: 

About two months ago I treated a lady for a small, watery ulcer, on her neck near 
the shoulder. It had troubled her for years, and largely because it would be chafed by 
the collar or neck band of her dress. It would scab over and heal for a short time 
and then it would break out again. I made one application of Hydrozone, full strength, 
until the scab was entirely eaten off and the ulcer thoroughly clean. Then pineoline 
was applied on a piece of cloth and kept renewed once or twice a day. In two weeks 
the ulcer healed over nicely, and has remained well ever since. She has taken no extra 
precaution about chafing of collar or neck band, either. 



197 

SHORT NOTES ON THE VALUE OF HYDROZONE IN 

VARIOUS DISEASES. 

. By S. J. Wimmer, M. D., and F. S. Parsons, M. 1). 

(Taken from The Physicians* Vade Alec ion.) 

(Published by The Medical Publishing Co., 718 Betz Building, Philadelphia, Pa.) 

The quotations extracted from this work are taken from paragraphs on the treat- 
ment of the various diseases enumerated, from the midst of much material of value 
to the general practitioner. 

"Stomatitis. — Wash out the mouth frequently with one part Hydrozone in six parts 
of water and administer glycozone internally after each n,eal to subdue inflammatory 
conditions of the stomach." p. 17S. 

" Retro-P /laryngeal Abscess. — When the abscess has been opened pus should be 
destroyed by spraying the pharynx with a mixture of Hydrozone one part and water 
three parts." p. 180. 

"Oesophagitis. — One tumblerful of ozonized water made of Hydrozone one ounce, 
water two quarts, as a drink three times a day and one teaspoonful of Glycozone after each 
meal will accomplish a cure," p. 181. 

"Chronic Gastritis. — A tumbler full of ozonized water made of one ounce of 
Hydrozone to two quarts of water administered as a drink three times a day; Glycozone 
two teaspoonfuls before each meal," p. 183. 

"Membranous Enteritis. — Wash out the intestines every morning with ozonized 
water made of one ounce of Hydrozone to one quart of lukewarm water. Do not 
mind the momentarily distressing symptom which accompanies this enema. Every 
evening administer an enema of Glycozone one ounce water twelve ounces," p. 192. 

"Dysentery. — Irrigation with warm water and Hydrozone as practiced by Dr. 
Lee is well recommended. The same treatment is also recommended in cancer of the 
intestines," p. 194-6. 

"Cholera. — Cholera Infantum. — Large irrigations of hot water made soapy is 
introduced into the colon through a suitable rubber tube and the stomach cleansed with 
Hydrozone given in half cupful doses together with hot water freely. This is a perfect 
antiseptic and should be continued until convalescence is established," p. 225 and 321. 

"Diphtheria . — Hydrozone to disinfect the discharges and destroy the germs and 
remove false membrane, it is thorough, quick and effective," p. 234. 

" Typhoid Fever. — Hydrozone one ounce, water twenty-four ounces as a beverage 
to disinfect the alimentary canal," p. 256. 

"Measles. — Inflammatory condition of the mucous membrane of the throat and air 
passages will be promptly subdued by spraying with Hydrozone one part, water eight 
parts." p. 60. 



RATIONAL TREATMENT OF PERTUSSIS. 

By FRANCIS T. P. FEST, M. D„ Plank Load, Mich. 

(Published by The Journal of the A merican Medical Association, Chicago, Aug. 17, 1895.) 

With every disease its etiology shows us the way for its treatment. Therefore it is 
necessary to recapitulate the etiology of every disease for which we wish to outline the 
therapeutics. 

Pertussis or whooping cough is a contagious disease, which manifests itself in spas- 
modic cough. Although some bacteriologists have found in the sputum-bacilli, we are 
unable so far to determine their role, whether cnusing, accompanying or only accidental. 



198 

It is a local disease of the larynx, acting upon the nerve supply, and causing spasms of 
this organ. The course of the disease shows three distinct phases, the catarrhal, par- 
oxysmal and declining. 

The first stage shows only symptoms of mild catarrh of the bronchi, nose or con- 
junctiva. Pathognostic for pertussis is only the excessive watery secretion from the 
affected regions. This phase lasts from two to seven weeks, with infants often a few 
days only. 

The paroxysmal stage affirms the diagnosis by its characteristic "whoops." The 
expectoration is watery, sometimes bloody. In many cases vomiting follows the par- 
oxysms by mechanical irritation. The vomiting in return can cause disorders of the 
digestive apparatus. The whoops at times occur as often as every half hour, and as 
thereby the cyanotic condition which accompanies the whoops occurs too frequently, 
they lead to asphyxial convulsions and even death. 

In the respiratory apparatus the irritation causes, in many instances, capillary bron- 
chitis and catarrhal pneumonia. After duration up to ten weeks the paroxysms are 
less severe, show themselves more rarely and the disease goes over into the declining 
stage. At this time the sequeloe or secondary lesions mainly demand our attention. 

As we have seen, the disease is a local one. It primarily affects only the larynx; 
all other symptoms are secondary. The circumstance forms the basis of our treatment. 
The disease is local — ergo, we treat it locally; it is of neurotic character — ergo, we give 
a drug that acts upon the nerves. 

With contagious local diseases, rational local treatment consists in destruction of 
the contagion by antiseptics — the most powerful is the most rational. Therefore every 
local application of any antiseptic improves to a certain degree pertussis. If we cast a 
glance at the literature, nearly everything was tried; phenol, boracic acid, thymol, 
resorcin, naphthalin, creosote, benzol, bromoform, mercurials, etc., but they all more 
or less are of irritating action upon the surface they are brought in contact with, or if 
not irritating their action is so mild that their therapeutic effect is as mild too. The 
experience of the last few years proved the superiority of Peroxide of Hydrogen over 
all other antiseptics, except when we have to handle metallic instruments. An excep- 
tion which interferes not in pertussis. 

In pertussis, I used the Peroxide with great success for local applications in this 
way: the child's head is leaned backward and held firmly, another person pulis out and 
depresses the tongue to bring the glottis into good view; then by means of a bulb ato- 
mizer consisting of glass and rubber only, I direct a spray of Peroxide of Hydrogen 
solution towards the larynx and if possible through the glottis. This is much facilitated 
if the child is old enough to pronounce the sound a. 

I always prefer the 30 volume Peroxide of Hydrogen (Hydrozone) and dilute it in 
the following manner: Hydrozone, one part; distilled water, ten parts; glycerine, one 
and one-half parts. 

If the parents are docile they can be instructed to repeat the application twice or 
thrice a day. If the physician has a chance to apply it himself, he does well to make 
the solution fresh every time. At all events it should be made fresh every other day on 
account of this mixture being unstable. 

Of all drugs only one has a really aborting influence upon pertussis, the old reli- 
able, often abolished and always restored belladonna. The only secret of its right 
administration is the circumstance that we have to give such doses to get the belladonna 
action; the flushes, (Jacobi); otherwise the administration is without value. 

A child of 2 years requires 6 drops of the tincture, three times a day; with the age 
the dose has to be increased to the proportion of 1 .00 as a maximum single dose for an 
adult (gtt. xxv). 

The root, the extractum alcoholicum fluidum can be given to infants of six to eight 
months in doses of 0.01 t. i. d., children of 3 to 4 years require of thesameo.3. Atro- 
pin may take the place of belladonna, beginning in a child of two years with o. 0006s 
t. i. d. and increase proportionately. 



i 9 9 

All complications must be abated in time, else our patient will be emaciated. If 
vomiting occurs at the paroxysms, give menthol. If there be gastritis and catarrh of 
the bowels, give calomel, bismuth, or still better Glycozone. Often we meet gastralgia; 
then I prescribe for a child over 2 years: 

1$ Belladonnas tinct. 2.00 
Mentholis 2.05 
Spir. frumenti 10.00 
Glycerini 20.00. 
M. D. S. Teaspoonful every two hours. 

Glycozone administered in the proportion of two teaspoonfuls, diluted in a wine- 
glassful of water, gave me the most gratifying results in acute cases. 

Are the paroxysms severe, we can easily control the spasm by an application of 
cocain to the larynx. 

For the general treatment we shall advise fresh air, good nourishment, tonics and 
inhalations of ozone. With such treatment the disease can be cut off to a period of 
onlv a few weeks. 



Editor of New York State Medical Reporter, of Rochester, N, Y. : 

In your July number you call the attention of the profession to a report from your 
issue of January, 1895, to a reprint of the Times and Register, Philadelphia, of an 
article by Dr. Endemann, chemist, of the relative value of the Medicinal Peroxide of 
Hydrogen preparations found on the market. In it he condemns No. 8, Oakland. In 
a subsequent examination he states that he did not discover any traces of baryta, and that 
it is in strength equal to all claimed by them. The experience of the Williamsport Hos- 
pital is large in the use of the Peroxides of Hydrogen. Comparing Oakland, Squibb's and 
Marchand's, we find that Marchand's is cheaper at a larger price than either Oakland 
No. 8), or Squibb's, as a smaller amount produces a larger oxidation.* 

Respectfully, 

B. H. Detwiler.M. D., 
Aug. 5, 1895. Williamsport, Pa. 



-MEDICINAL TREATMENT OF TYPHOID FEVER. 

By GUSTAVUS BLECH, A. B., M. D., Detroit, Mich. 

(Read before the Meeting of the Mississippi Valley Medical Association, Sept. 6th, 1895.) 

We have no specific treatment for typhoid fever. Hygienic and dietetic treatment 
alone are not sufficient, and although the so-called abortive treatment of this malady is 
nothing else but an illusion of a few optimistic physicians, there are a good many reme- 
dies known which will influence considerably this disease. 

As late as twelve or fifteen years ago the treatment was symptomatic only, the 
attention being directed especially to the high fever. At that time patients died with a 
low temperature. 

To-day our treatment is more rational. We have investigated into the cause of this 
disease, found it to be of microbic origin, hence we treat typhoid fever antiseptically. 
The germs are found principally in the intestines, hence we will employ intestinal anti- 
septics. I will speak of it later. 

♦See p. p. I to V,also p. 154, Reports by Dr. H. Endemann, Prof. L. D. Kastenbine and Dr. J. P. 
Parker. These reports establish the relative value of the different brands of Peroxide of Hydrogen 
which are found in the market. 



As an antipyretic, quinine was a favorite about fifteen years ago. Af present its 
use is considerably reduced and modern antiseptics (phenacetine, antifebrine, antipy- 
rine) have been substituted. Hydropathy has a great many friends. On the other hand 
the number of opponents cannot be underrated. Medicinal antipyretics in infectious 
diseases are dangerous, as they oppress the heart. I treat the fever if it reaches a high 
degree internally with alcohol (wine, cognac) externally sponging with a twenty per 
cent, aqueous solution of alcohol. 

Now to the antiseptic treatment. Intestinal antisepsis is the parole. My previous 
experience with Hydrozone in gastric and intestinal affections in both adults and chil- 
dren induced me to try it in typhoid fever. See my report headed "The Rational 
Treatment of Cholera Infantum," published by the New York Medical Journal, (March 
2d, 1895). I note with pleasure, that the editor of the Mirror, Dr. I. N. Love, of 
St. Louis, the well known teacher of Paediatrics, in an editorial in the June issue of his 
valuable monthly, fully agrees with my methods. 

I found Hydrozone not only to be a good antiseptic but a splendid remedy against 
the stupor, in which all of my patients were laying and which clearly proves that the 
cases that I had to deal with were serious. 

Soon after a few doses of Hydrozone (diluted with water 1 to 32) were adminis- 
tered, they felt comfortable, the semi-unconsciousness ceasing. I think the blood and 
blood corpuscles become saturated with oxygen and thus the brain is kept in activity. I 
alternate the internal treatment between Hydrozone, hydrochloric acid and alcohol. 

Hydrozone has proved to be in my hands, more powerful than any other antiseptic, 
and yet it is harmless. As a direct medication I irrigate the bowels of every typhoid 
fever patient with four quarts of clear water to which two ounces of Hydrozone are 
added. I would repeat this procedure twice daily. Depending on the temperature of 
the body, I would use cold water in high fever, otherwise lukewarm w r aterwill be more 
agreeable, and accomplish the same purpose. Irrigation of the bowels with cold water 
has also an antipyretic effect. Such irrigations will also check the diarrhoea and en- 
courage a natural catharsis. They also reduce the hyperemia and inflammation of the 
intestinal mucous membrane, annihilate the bacilli and if ulceration be present, will 
stimulate granulation and produce a healthy surface. This irrigation with diluted Hy- 
drozone is the best remedy to prevent perforation of the bowel. 

In order to obtain the desired results from irrigation, we must introduce the rectal 
tube beyond the sigmoid flexure. The tube which should be neither too flexible nor too 
stiff, must be well oiled and carefully introduced. In this way, the fluid will enter even 
the caecum and reach the seat of the disease. 

The treatment as I have outlined in this paper will not only have a curative effect 
but will also prevent the usual complications. Of course, symptoms, which per se are 
liable to influence the disease or endanger life itself, must be treated accordingly. 
In conclusion I beg to submit a short report of six cases in which the above treatment 
was successful. 

Case i. — Otto S., German, shoemaker, aged 24. Saw him first August 14, 1894. 
Has been actually sick but a few days, although as he said, he felt ill for over a week. 
Headache, slight chills, thirsty, constipated, temperature 102.5 slight cough. Physical 
examination of chest and abdomen gives negative result. Could make no definite diag- 
nosis. Prescribed calomel and bicarbonate of soda. Saw him again on the 16th. 
Temperature almost 104. Could feel swelling of the spleen. Tympanites. Sleeps bad 
in night time. Diagnosis. Typhoid fever. I ordered at once diet and sponged the body 
with diluted alcohol. Temperature taken five minutes after sponging 102. On the same 
evening I made an irrigation of the colon. A good deal of fecal matter was evacuated. 

August 17, Fever 104 degrees. Arrhythmia of the heart. Headache intense. No 
appetite. Sponging of the body by nurse. Irrigation whenever fever high was 
ordered. Hydrochloric acid. 

August 18, same symptoms. Stupor. Has been delirious all night and appeared 
apathic when visited. Same treatment. 



201 

August 19. Same symptom?, Roseola. Prescribed Hydrozone diluted. Rested 
well this night. Old treatment continued. 

August 20. Appears brighter. Asks many questions as to his disease. Wants 
to know whether his disease, the character of which was not disclosed to him, is infec- 
tious, and if so, wishes his younger sister removed. 

August 25. Slight haemorrhage from the bowel followed by a state of semi-collapse. 
Was called in a hurry. A hypodermic injection of sulphuric ether was administered 
which improved his condition soon. Irrigation of the bowels with diluted Hydrozone 
was now made twice daily. 

Patient was discharged September 2, and advised to observe diet and to remain in 
bed for a week. Complete recovery. 

Case 2. — Miss Agnes T., Irish- American, actress, age 21, of a nervous tempera- 
ment. Saw her first, August 25. Patient looked pale and emaciated. She described 
her condition as due to over-work and mental strain. Has been sick for over a week and 
was treated by an Eclectic physician. Had all marked symptoms of typhoid fever which 
diagnosis was confirmed on the next day. The treatment in this case was similar to the 
former with the exception that I had to resort to the wet pack on the 30th as the tem- 
perature, 104.5, was n °t reduced by the sponging. Although the dry tongue and lips 
indicated a grave disease, the patient was always conscious and able to talk, which I 
attributed to the administration of Hydrozone. She made a good recovery after an ill- 
ness of four weeks, three weeks being under my care. Patient left town to join a com- 
pany in October, 1894. 

Case 3, was that of a robust smith, Peter R., aged 30, married, father of four 
children. He was first seen by a Senior student, now a physician, practicing for a 
living at that time under my supervision. He did not make a definite diagnosis attrib- 
uting his fever to a cold, and prescribing pilocarpine and antipyretics. He called me 
in consultation August 20, fearing death of the patient. Temperature J05, pulse no. 
Arrhythmia, stupor, swelling of the spleen was rather difficult to be determined, but I 
could feel an increase of its volume by palpation. Tympanites. No roseola, dry lips, 
dry tongue. 

I advised sponging which reduced the temperature at once to 103. Hydrozone 
was given, one ounce to a quart of water as a drink. Irrigation of the colon with cold 
water and Hydrozone was practiced, and the patient's general condition improved the 
very evening. Mr. K., the medical student, continued the treatment, with irrigations 
and sponging and prescribed internally, digitalis, strychnine and Hydrozone. Patient 
made a good recover}'. I cannot say when he was discharged, but Mr. K. informed 
me that he never saw him in such a grave condition any more. With moderate symp- 
toms, he recovered after two or three weeks. 

Case 4. — Joseph S., waiter, born in Polish Russia, aged 19, eight years in this 
country, was never sick during that time. He complained of general weakness, chilly 
feeling, headache, etc., and thought the "Indian summer," as the warm fall of St. 
Louis is called, were obnoxious to his health, and that he contracted malaria. There 
were no chills, however, only a slight rise of the temperature. I saw him first, Sep- 
tember 19, but did not think much of his trouble. I prescribed Mariani wine and 
patient really felt better. Was called again September 24th and found patient in bed. 
He told me he sometimes felt cold, sometimes warm. Temperature 101. 5, pulse 90. 
Is thirsty and desires no food. Thinking of malaria, I prescribed 10 grains of quinine 
ter per diem. Conditions the next day worse. I made a different diagnosis when I 
visited him the next day, namely, typhoid fever. Patient was treated on the same prin- 
ciples as the former, but got pneumonia during the state of convalescence. After an 
illness of four weeks however, he completely recovered. 

Patient contracted in November, gonorrheal urethritis, which proves that the 
double malady left very little impression on him. 

Cases 5 and 6, were sisters living in one house. A widow Mrs. L. aged 32, and 
Mrs. B. ; married one year. Both had no children. Mrs. L. took sick September 



24, and called me the next day. Mrs. B. took sick September 29, and both sisters 
made a good recovery. Whether one infected the other, or whether the infection came 
from a general source, I do not know. There was nothing unusual in'the course of their 
diseases, the same being of rather a moderate character. After two weeks' treatment 
both were discharged well. 

The. characteristic fever curve, the swelling of the spleen, tenderness in the iliac re- 
gion and roseola, left no doubt as to the diagnosis. 

The younger sister was treated by me until March for anaemia with iron and mal- 
tine. She was not anaemic before, and this condition must be regarded as due to and 
following the attack of typhoid fever. When I left St. Louis (in March) the anaemia 
was much improved. She felt stronger and objected to be treated by a physician de- 
claring that she feels the maltine and iron preparations will bring her back to lull health. 



MALIGNANT SORE THROAT AND ITS TREATMENT. 

By J as. Osbourn Dk Courcy, M. D., St. Libory, III. 

(Read before the twenty-first annual meeting of the Southern Illinois Medical Associa- 
tion, held at Carbondale, 111., May 9 and 10, 1895.) 

(Published by the Courier of Medicine, for July and August Issues.) 

It is in compliance with special request from your distinguished president that the 
author ventures to add a word upon a subject which for several months past has received 
more scientific thought, perhaps, than any other one subject which concerns the pro- 
fession from a pathologico-scientific standpoint. There are various forms of sore throat 
which may be called malignant; but the attention of this Association is directed by this 
paper to that acute specific, contagious disease, beginning by an infection of the throat, 
characterized by local exudation, glandular enlargements, systemic poisoning, and hav- 
ing various paralyses for its sequelae. The technical name by which is it generally called 
(derived, as it is, from the Greek dip/it/iera, leather, and dipho, soften) at once portrays 
the peculiar nature of the pathological condition, and when the soft, leathery-like mem- 
brane has been formed and observed by the physician, a picture that cannot be eraced 
is engraved on his mind. This malady has ever been a terror to the faculty, as well as 
to the laity, whenever and wherever it has made its appearance. Since the profession 
has had so much literature upon this subject from so many different standpoints, 
through the medical press during the past year, it seems that any lengthy scientific ex- 
egesis of the subject at this time could scarcely be expected. 

The more salient points, therefore, will be touched, some personal observations 
given along the line, the gate set ajar that the members present may enter the field, 
unveil the materies morbi y and discuss their modus operandi, ad libitum. As to the 
cause of the disease the opinions of authors and pathologists of eminence have been 
at variance, and may yet be said to be divergent. Hueter, Oertel and Virchow were 
among the first to advance the opinion that micrococci produce the pathological condi- 
tion, and, therefore, comprise the primary cause of the disease. On the other hand, 
in concord with various dissenting voices, by certain filtration experiments made by 
Burdon-Sanderson, serious doubts were cast on micrococci as the immediate agency; 
but they are found to be necessary from either- standpoint, and a secondary role 
named by the experimenter as "being consequent upon their functional activity. 
More recently it has been scientifically demonstrated by a number of German patholo- 
gists, to the satisfaction of a portion of the profession, that this belongs to the list of 
bacteriological diseases. 

The reasons and demonstrations set forth to establish the germ theory, so far as- 
this disease is concerned — to the author, at least — seem conclusive, other opinions, 



203 

possibly that of some of you, to the contrary notwithstanding. In regard to the con- 
tagious, infectious nature, the sporadic, endemic and epidemic prevalence of the dis- 
ease, it is scarcely necessary to make mention; neither its seeming alliance with scarlet 
fever, nor yet of its simultaneous appearance during epidemics of small-pox, measles, 
puerperal and typhus fevers. The contagion in the poisonous exudations and secre- 
tions of the fauces is, without doubt, the chief cause of its spread. The author believes 
the variation in the period of incubation to be due to several causes, among which may 
be mentioned the physiological or pathological condition, the age and surroundings of 
those exposed .to and infected by the germs. From the standpoint of patho- 
logical anatomy, the first perceptible change is the injection of the mucous membrane 
o f the fauces, quickly followed by hyperemia of the tonsils. At the end of thirty hours 
or so a grayish pellicle appears on the tongue, and soon is visible elsewhere on the soft 
palate^ uvula or tonsils. At first these patches are thin and scattered, but in a very 
short time coalesce. Very soon the army of micrococci marshal their forces, and press 
their way through the mucous membrane at whatever point may be the least strongly 
fortified. At and around this point the forces assemble as they pass through the broken 
wall, and at once proceed to throw up a very singular fortification — the false membrane. 
The constituent parts of this membrane, its office, extention into the nares and air pas- 
sages, its various changes, together with the special forms of the disease, are intention- 
ally omitted, with the hope that the more important points may be brought out by the 
discussion. Little oportunity is offered the general practitioner, outside of hospitals, 
for accurate observations of the inroads made by the disease on the various organs of the 
body. 

Symptomatology. — In the mild or catarrhal form the symptoms are -similar to those 
of acute pharyngitis, or tonsilitis: soreness, pain and irritation are felt in the throat, 
especially on attempting to swallow, and general malaise may follow. In other subjects 
of a nervous excitability, or those who are laboring under some pathological condition 
at the time affected, the symptoms may be much more severe. Nausea and vomiting 
may follow, marked headache, fever and sore throat. On ocular examination the tonsils 
are found oedematous, the mucous membrane of the fauces infiltrated, and membranous 
patches are present. So great may be the cedema of the tonsils that a fatal climax may 
be reached before the false membrane is produced. A thick white coating soon covers 
the tongue. In two or three days the false membrane appears in one or more places, 
spreading over a considerable space in a few hours. The membrane, at first thin, con- 
stantly grows thicker the longer it remains undisturbed. The color, at first a creamy 
yellow or a grayish white, gradually changes to a dark red as the disease advances. 
About the fifth day the disease may take on the more severe form and violent symptoms 
follow, the temperature rising to 103 to 105 ° Fahrenheit. The soreness on attempting to 
swallow is very acute, and in a few hours the membrane appears either on the palate, 
uvula or tonsils. In removing the tenacious membrane the mucus is peeled off with it 
and a raw surface left through which the blood percolates. Should no attempt be made 
to remove the false membrane and to arrest its reproduction it will spread rapidly, pass- 
ing up the nares and down the tubes penetrating the air passage. Thus the blood con- 
stantly taking on poisons from the debris of the fungosus, the whole system is saturated 
with the infection, and a septic, or gangrenous condition produced. Possibly this con- 
dition of things may be spared by earlier termination of the case, by spasm of the 
glottis, occlusion of the bronchi, pneumonia or carbonic acid poisoning. It is during 
the septicaemic stage that the membranes take on the darker color, that the odor from 
the breath and discharges become foul and offensive. At this time, as a rule, there is 
but little elevation of temperature, if any at all; slow and irregular pulse. Next gan- 
grene sets up, and a fatal termination ushered in by paralysis of the heart. Numerous 
are the causes which influence the behavior, course, duration and termination of malig- 
nant sore throat. The mortality is great, though no precise statement of mortality 
rates has yet been made. The prognosis should be very guarded, and is usually grave; 
is augmented the more virulent the case from which the infection was obtained. For 



204 

obvious reasons, the mortality is' greatest in infants and young children. Good nurs- 
ing has a decided influence upon the course of the disease, and should always be con- 
sidered in estimating possible results. Extension into the nares and larynx are alarm- 
ing symptoms; likewise bleeding, vomiting, purging, low temperature, cold and clammy 
skin and slow and intermitting pulse are premonitors of evil. 

Cases apparently favorable have suddenly ended by paralysis of the heart. As re- 
gards the hopefulness of recovery from the various forms of this disease, the catarrhal 
stands first, the croupous second, and lastly the septic or gangrenous. 

Paralysis of various parts and organs of the body are prominent among the 
sequelae which often follow the ravages of this disease. It may come on at once, be 
delayed for several days, or even some weeks. Fortunately, however, this paralysis is 
quite amenable to treatment. It is hoped that the discussion will bring out the patho- 
logical condition thus produced upon the nervous system, organs of circulation and 
respiration. To make a prompt and positive diagnosis in all cases is a most difficult 
task. At present eminent authorities in bacteriology teach that the only actual scien- 
tific diagnosis that can be made is by use of the culture fluid or microscope. A por- 
tion of the suspected exudate is immersed in the Klebs-Lceffler fluid, which is fur- 
nished in sealed glass tubes. After the fluid has been inoculated it is set away in a 
warm, dark place (98. 6° Fahrenheit is about the required temperature) for the space of 
twelve or eighteen hours. If the micrococci of diphtheria are present they will by that 
time have produced a growth in the fluid which will be perceptible to the unaided eye. 
This method is not accepted by all. The microscope is regarded as Ihe most accurate 
method by which to make a scientific diagnosis. The author has never yet seen two 
cases that were exactly alike, either in symptoms or in the local manifestations. Before 
the false membrane has been formed it is easy to confound the catarrhal variety with 
acute follicular ulceration of the tonsils, or amygdalitis, owing, principally, in the last 
case to the intense (edema of the tonsils. Especially is this true when there are no 
other cases of the malady in the neighborhood, and when, so far as known, the patient 
has not been exposed to the contagion from any source. That it has been confounded 
with croup there is little room for reasonable doubt. 

Since croup is simply a local affection, non-contagious and not infectious, is with- 
out the characteristic general symptoms of malignant sore throat; for these reasons the 
non-identity of the two diseases seems perfectly patent. There is some analogy between 
malignant and scarlatinal sore throat, but the whole mucous membrane of the fauces is 
intensely red in scarlet fever, while in malignant sore throat the redness is limited to 
the infected area; in scarlet fever the exudation is soft like curds, and usually scattered 
over both tonsils and the palate. In malignant sore throat the membrane begins at one 
point (sometimes more), adheres closely to the epithelium, and has a characteristic 
color. In scarlatina the symptoms are much more severe; high fever, with vomiting, 
delirium, or convulsions, commonly inaugurate the disease, which are wanting in malig- 
nant sore throat. At the expiration of twenty-four hours the rash appears in scarlatina, 
but is absent in malignant sore throat. 

Treatment. — Believing that local infection is the true cause or the disease, the fol- 
lowing treatment is suggested, being based upon the validity of the germ theory. Ra- 
tional treatment necessarily resolves itself into two distinct divisions: preventive and 
active therapeutics. In every case where preventive medicine is timely, faithfully and 
scientifically applied, the mortality should be zero. Unfortunately, however, this mode 
of treatment is at present impracticable in very many cases. In the application of pre- 
ventive measures, the establishment and maintainance of normal physiological condition 
is of primary import. 

Abundance of sunshine, the greatest of all purifying agents and germicides; good 
hygienic surroundings, absolute cleanliness indoors and out, internal and external, are 
axioms, so to speak, which should form the basis of treatment in all cases. When the 
disease has appeared in any locality the whole population should be informed at the 
■earliest possible moment, so that suitable precautionary steps may be taken to suppress 



the outbreak. The mouth and throat of all children who are under fifteen years of 
age and living in the infected district should be carefully examined from day to day. 

Mouth washes, gargles and sprays of trustworthy germicide agents, should be 
freely used in every famiiy where there are children, and especially among the young 
children, as well as all those who may be exposed to the poison. There are many germi- 
cides in active use, but the author has obtained the most satisfactory results from the use 
of Hydrozone. No ill effects are consequent upon the extensive use of Hydrozone, 
and when diluted can be given internally to the new-born infant. Immunity of chil- 
dren produced by the new and very popular agent, antitoxic serum, before, or at least 
as soon as exposed to the infection ; is already regarded by some as the best known pre- 
ventive and active treatment. There are many things which conspire to influence 
the active treatment — the age of the patient, his physiological or pathological 
condition at the time he is infected, the length of time the poison has been in the sys- 
tem when the physician first sees the case, the particular form of the disease and the gen- 
eral surroundings of the patient, are all to be noted, and are worthy of careful consid- 
eration. The earlier the disease is recognized and the sooner the treatment is begun 
the better will it be for all concerned, and the greater the chances for recovery. As 
venom by the sharp fang implanted beneath the skin quickly ramifies every part of the 
living organism, producing general toxic effects, so it is in this disease; the infection 
from a single spot migrates into every nook and corner of the system. For complica- 
tions that may arise during the course of special cases no prescribed plan of treatment 
would apply. The physician in charge is at the helm; wisdom and good judgment 
must be brought into play as compass and needle to direct him in the skillful manage- 
ment of the case, so that, as the vessel advances through the tempest, the rocks and 
sand-bars lying concealed along the way may be avoided. Solutions of silver nitrate, 
iron chloride tr., perchloride and glycerine, acids (salicylic and carbolic), potash chlor- 
ate, borax, etc., have been in use as local application for a long time; but they are 
dangerous agents, and the author does not use them. He has found nothing superior 
to Hydrozone. It accomplishes all the good that can be obtained from any local ap- 
plication, routs the enemies from their strongholds, kills the invaders and destroys their 
fortifications. It is quite safe and free from all untoward after-effects which often fol- 
low the use of some of the other therapeutic agents, can be used in full strength, or 
diluted, as a spray, gargle, taken internally, or used on cotton probang to mop up the 
"beasts." It should be used every hour, day and night, until the false membrane ceases 
to be reproduced, and every particle of the membrane destroyed at each seance. If 
the fungosus be removed early and kept removed hourly it is very quickly destroyed by 
Hydrozone, when applied in full strength. When the growth extends into the nares 
diluted Hydrozone should be sniffed up the nose, or the nasal douche and spray thor- 
oughly and frequently used. 

After the poison has become general the systemic treatment is quite as important 
as the local. The treatment should be directed against the malady from a double stand- 
point, to limit spreading of the local disease and to prevent, as far as possible, systemic 
infection. Ammonia bromide, iodine (used singly and combined), iodine comp. liqr. 
and acid carbolic, quinine, and alcohol have been extensively used as constitutional 
antidotes to the poison of malignant sore throat. Since the appearance of antitoxic 
serum in therapeutics the mortality of this disease has been so much reduced in the 
various hospitals and infirmaries where it has been used, it has supplanted other agents 
or reduced them to places of subordination, at least for the time being. 

The author's experience with antitoxin is quite limited, having used it in three 
cases only; but in each case the results were all that could have been expected by the 
most sanguine. The serum used was manufactured by the Biological Association of 
New York, under the direction of the Pasteur Institute. They claim to be the original 
American manufacturers of the new remedy, and that it is identical with that used by 
Dr. Roux, of Paris. The results following its use, as reported by the institutions and 
physicians who have experimented with it, are very gratifying; and unless "It is possi- 



2o6 

ble that the very elect are deceived" the antitoxic serum therapy is a success. The im- 
munizing dose is from c. c. t. to c. c. vii, depending upon the age and condition of the 
patient. The medicinal dose is from c. c. v. to c. c. xxv, given at one injection, re- 
peated one or more times should it be deemed necessary. The earlier the injection is 
given the less will be the quantity of serum required in any given case. Stimulants and 
quinine may perform beneficial functions, but nourishing aliments are necessary from 
the beginning. Beef essence, eggs, egg-nog, pure milk and malted milk (Horlick's 
malted milk is equal to the best) are suitable articles of food for diet. They can be 
changed and interchanged trom time to time throughout the course of the disease. 
Nourishments should be given at short intervals in order, if possible, to prevent collapse. 
It is scarcely necessary to add that ever)' precaution should be taken by physicians 
and nurses to ward off infection. The cloths of the patient and nurses, the bed, bed- 
ding, furniture, and apartments occupied, should be thoroughly disinfected. The 
judicious use of quinine, iron, strychnine and electricity will promptly subdue paralysis 
that may follow or result from a course of malignant sore throat. 



THE THERAPEUTICS OF SPECIFIC URETHRITIS. 

By CHARLES P. WAGAR, M. D. 

(Read before the Toledo Medical Association November 9, 1894.) 

(Abstract from the Teledo Medical and Surgical Reporter for December, 1894.) 

A great many cases of gonorrhoea are supposed to be cured, while there still remains 
in the epithelial covering of the urethra, or the pockets and glands far back in the pros- 
tatic portion, a quantity of the gonococci which are not yet in active, irritative and 
aggressive condition, yet they are present and may become dislodged, and pass out with 
the urine or with the semen in sexual intercourse, and in the latter case they are injected 
into the female vagina and may be productive of serious trouble. At the onset of the 
disease, in order to render the urine as bland as possible I order fifteen grains of bicar- 
bonate of soda, well diluted, every three hours, a brisk saline cathartic at bedtime, a sitz 
bath in 1 to 5,000 bichloride solution hot as can be borne, three times a day. Painful 
erections at night are benefited by half grain morphine suppositories, being preferable to 
the bromides. 

I do not permit a patient to use a syringe at any stage of the disease if I can help 
it. As a rule putting a syringe into the hands of the patient is crude and unscientific. 
They will not use the injection regularly, and frequently insert the syringe in an improper 
manner. If I see a patient before the inflammatory stage has set in I have him come to 
the office morning and evening and then proceed to thoroughly irrigate the urethra with 
two quarts of bichloride solution (hot) 1:15,000. 

Liberal and frequent irrigations of Peroxide of Hydrogen (Marchand's),* half strength, 
at the onset of the disease has frequently been attended with the best of results. If I 
do not see patient early, injections are not used until after the inflammatory stage has 
subsided. Another remedy that has given good results is a capsule (Merz Compound 
Sandalwood No. 128) composed of sandalwood oil, balsam copaiba, haarlem oil and oil 
cassia. This combination gives better results than either of the drugs administered 
alone. I have not had enough experience with any remedy for gonorrhoea to claim for 
it a "sure cure." 

* When Hydrozone is used instead of Marchand's H2O2 medicinal, it should be diluted in the pro- 
portion of 1 part Hydrozone for 4 to 16 parts of water, according to the degree of sensitivenes of tha 
mucous membrane of the urethra. 



THE DIAGNOSIS AND TREATMENT OF THE DISEASES 
OF THE ACCESSORY SINUSES OF THE NOSE. 

By WM. ELLERV BRIGGS, M. D., Sacramento, Cal. 
Read before the California Northern District Medical Society. 
(Abstract from the Occidental Medical Times, of Scramento, Cal., for September, 1895.) 
* * The following case is one of Empyema of the Ethmoidal and Frontal 
Sinuses. A. M., aged 6S, farmer, had been suffering intense pain located in the 
frontal region, and below the eyes, for five weeks. He had been obliged to resort to 
anodynes several times daily to lessen the severe pain. The conjunctivae of both eyes 
were greatly inflamed; the right lids were edematous. A hard tumor could be feit in the 
swollen cellular tissue in the upper part of the right orbital cavity which displaced the 
eye downward and outward. There was considerable hypertrophic rhinitis and some 
polypoid growths in the vicinity of the infundibulum. An incision was made into the 
orbital tumor, the cavity washed out with Peroxide of Hydrogen (Marchand's) and the 
wound packed with iodoform gauze. The nasal polypi were removed and the nasal 
hypertrophy reduced to some extent, but on account of the patient's dread of operative 
treatment, the natural drainage was not established nor the discharge through the orbital 
sinus cured. The relief from pain being complete and the few drops of glairy mucus 
which continued to discharge through the orbital sinus, causing the patient little incon- 
venience, he declined further operative treatment. The slight secretion from the orbital 
opening has persisted during the past two years, and is likely to continue indefinitely 
unless better drainage is established through the nose or the sinuses are opened and the 
pyogenic lining to the cavities curetted out. * * * 

* * * The following case is one of Traumatic Empyema of the Frontal Sinus: 
J. L. R., set. 30, carpenter, was struck on the right brow by a falling hammer. He 
had occasional pains in that region, but no urgent symptoms until he presented himself 
for treatment about six months after the injury. He had been suffering intense pain in 
the region affected for two weeks. A hard tumor, about the size of a small hazelnut, 
could be felt just internal to the middle of the roof of the orbit. The lid was edematous 
and could not be raised; the conjunctiva was inflamed; the eye was pressed downward 
and outward. There was some pus discharged into the right nasal cavity. The nasal 
cavity was healthy, with the exception of inflammation in the vicinity irritated by the 
pus. An incision was made into the tumor, and about a half drachm of pus was dis- 
charged. The cavity was washed out with Peroxide of Hydrogen (Marchand's) and 
packed with iodoform gauze. It was dressed daily, and at the end of five weeks, the 
secretion from the sinus and into the nose, had ceased, and the patient was discharged. 
About four months later the patient returned with all of his previous symptoms, pain, 
tumor, edema, etc. An incision was made down to the bone beneath the superciliary 
ridge, and considerable pus was discharged. A probe could be passed into the frontal 
sinus through an opening in the skull. With a sharp spoon and chisel, the diseased 
bone was removed, the cavity washed out with Peroxide of Hydrogen packed with 
gauze and dressed daily, as before. The peroxide flowed freely into the nasal cavity. 
After two months' treatment, the patient was discharged cured. 



TREATMENT OF THE NEURALGIC VARIETY OF 
DYSMENORRHEA. 

(Abstract from an American Text Book of Gynecology, pp. 11 7-1 18.) 

Published by Dr. S. M. Baldy, Prof, of Gynecology, Philadelphia Polyclinic. 

The treatment of this form may be subdivided into general and specific treatment. 

In the beginning of the treatment the physician must carefully ascertain the general 

state of the patient. If it is of the rheumatic, gouty, or syphilitic diathesis, this must 



2C>8 

be met by the usual remedies; in other words, the physician must treat assiduously the 
systemic condition which seems to predispose to the development of this neuralgia. The 
daily free administration of laxatives and diuretics is advisable. Should a local cause 
for the constipation be found in the anus or rectum, it should be removed by surgery 
or otherwise. Free daily evacuation of the bowels are indispensable to the restoration 
of the physiological balance of these patients. Constipation may lead to fecal anemia. 
In women thus affected neuralgic dysmenorrhea is extremely common. Rheumatism 
should be treated with colchicum, guaiac,the salicylates, and the preparations of potash. 
Gout requires the administration of minute doses of calomel, as one-twentieth of a grain 
three times a day, and with the citrate of potash or lithia. Syphilis calls for mercury 
and iodides. An anaemia demands tonics. An indulging fermentative dyspepsia 
which may be one source of degenerated general health, requires gastric lavation, creo- 
sote, glycozone and other antiseptic treatment. 



ELECTROLYSIS FOR THE SURGICAL TREATMENT OF 

STRICTURES.* 

By J. A. FORI', M. D., 

Professor of Anatomy in the Ecole Pratique <>( the Paris Faculte de Medecine. 
Published by the New York Medical Journal \ November 16, 1895. 

It affords me great pleasure to have the honor of being allowed through the kind- 
ness of your president to present to you a new instrument which I have devised and 
called "electrolyser," for the surgical treatment of strictures by the "linear electrol- 
ysis" method. 

It is a well-known fact that electrolysis has been discarded on account of the im- 
perfect instruments which were used. My electrolyser has all the advantages of the 
urethrotome and none of its inconveniences. It looks like a small whip of which the 
handle contains a metallic wire projecting from the end which connects with the flexible 
part. This instrument, being first introduced into the urethra, is connected with the 
negative pole of a continuous current battery, and the positive pole is connected near 
the affected part, on the front of the thigh or over the pubes; then the current is turned 
on. 

The operation, which is almost painless, requires thirty seconds (on an average), 
with a current of a strength of at least ten milliamperes, as indicated by means of a 
galvanometer. The electrolyser remains perfectly cool during the operation. In 
nearly all cases there is no bleeding, or but very little. The urethra is made aseptic 
before and after the operation, in order to prevent fever. I never allow a sound to re- 
main permanently in the urethra for any length of time after the operation. 

Usually the wound resulting from electrolysis heals quickly without any local 
treatment whatever, and often the patient can attend to business immediately after the 
operation. f In nearly all cases I pass a sound the third day after the operation, also 
the day after. I instruct a patient to pass a sound, No. 22 or No. 24 F., every month 
and every other month. 

*Read before the Section in Genito-urinary Surgery of the New York Academy of Medicine, 
Tuesday, November 12, 1895. 

+When the wound does not heal, T merely prescribe injections morning and evening with a mixture 
of one part of hydrozone to twenty parts of water. 



209 

With the urethrotome, which cuts blindly, the surgeon can not ascertain the degree 
of density of the tissue of a stricture. On the contrary, by means of electrolysis, which 




The electrolyzer, shown in two parts, on account of its length, i, i, the shaft; 2, the conducting por- 
tion: i, the platinum blade; 4, point of connection with the negative 
pole; 5, screw-head for fixing the conducting 
cord; 6, ivory push-button. 

merely produces a molecular destruction of the stricture, although the instrument re- 
mains cool, I have been able to demonstrate that there are two classes of strictures 

"soft and hard." Hard strictures are in the proportion of one against five soft ones. 

The time required to perform the operation varies with the density of the stricture. 

^ome strictures are so hard that they cannot be successfully operated upon by electrol- 



2IO 

If my American colleagues who are familiar with the French language are willing 
to refer to one of my books entitled Traitemeni des re'tre'cissements par V electrolyse 
line'aire (this book can be procured at the library of the Academy of Medicine), they 
may find it quite interesting, as it will enable them to understand the improvements 
which have gradually been introduced in the applications of electrolysis to surgery dur- 
ing the last fifteen years. They will also understand how I have applied electrolysis 
to the treatment of strictures of the urethra, uterus, rectum, and oesophagus. 

Up to date, I have performed in Europe a hundred and thirty-five operations on 
strictures of the oesophagus (recorded in my book), and with the exception of those 
which were caused by malignant growths of the wall of the cesophagus all recovered. 

It has been my good fortune to meet here some leading surgeons who are author- 
ities in the treatment of strictures, and I am very grateful to them for their kindness in 
giving me the opportunity to demonstrate the advantages of my method in operating 
upon some of their patients. 



CAN ANTITOXIN STATISTICS BE P.ELIED UPON? 
By GUSTAVUS BLECH, A. B., M. D., 

Surgeon to the German Free Dispensary, Detroit, Mich. 
Published by The Journal of the American Medical Association, for Jauuary 25, 1895 

The many fiascoes in modern medicine have taught me a lesson, viz : Never to 
be the first and never to be the last one, to adopt a new remedy. liberality is one 
of the first conditions for progress and success in medicine; conservatism, the prevent- 
ative of poetic illusions and errors, undiscovered on account of the blinding effect of 
enthusiasm. 

I have quietly watched the reports of cures of diphtheria with antitoxin, and have 
wondered how easy it is to catch the masses, even if one knows next to nothing about 
the modus operandi of a remedy. Besides, its origin and composition is mystery as yet, 
its preparation being controlled entirely by a few enterprising chemists. But neither 
this nor the fact of its introduction into the human system is apt to cause a good many 
dangers like leucocythemia, shall be brought as an argument against its value; even 
the fact that a good many eminent and thoroughly reliable physicians have reported 
their experiments with it as failures shall not be mentioned, and only one modest ques- 
tion shall be asked: Can antitoxin statistics be relied upon? I dare answer, no, not 
always. 

I do not doubt for one moment the honesty of the reporters and their noble inten- 
tions; for the sake of the honor of the profession I will say that "figurers will not lie," 
but I cannot help asserting that " figures will." The fact is, that every case reported 
as diphtheria, is indeed, not always true diphtheria. In some cases the microscopic 
examination alone was sufficient for a diagnosis, and that was false. In other cases, 
the physical signs, the clinical picture was the medium, and that was false also. Both 
together, microscope and thermometer, eye and hand, must be employed to obtain a 
correct diagnosis. 

Diphtheria, true diphtheria, in spite of horse, jackass or any other quadruped 
serum, is a grave, constitutional disease, the prognosis of which is always doubtful. It 
is exaggerated when one of my friends asserts, that he makes a diagnosis of true diph- 
theria post mortem only; but there is some truth in that intended joke. There are 
plenty of poor children running around the streets with sore throats, follicular tonsilitis, 
rhinitis fibrinosa and never take a drop of medicine and get well. And in some of 
these a physician is called in, and a few hours later the health inspector is placarding 
the house. If, by chance, the parents are smart enough to call in a more experienced 
physician, off goes the red sign. 



I had quite a number of such cases in my practice, but in one of my last ones I 
had an encounter with our local board of health, which ended in my victory. 

The case I refer to is that of a little boy,R. S., aged 4 years. He was taken sick with 
sore throat, and nose, the latter bleeding on touch, membranes being expelled on sneezing. 
A reputable physician was called who pronounced it diphtheria. He sent a culture to 
the local board of health where Klebs-Lceffler bacilli were found. For some unknown 
reason to me, the parents discharged the physician and called me in to attend the case. 
I made a careful examination of the nose and throat, found a somewhat accelerated 
pulse and a temperature below 100 degrees F. The boy ran from one room to another 
and would not agree to be confined to bed. "While the mucous membrane appeared to 
be, on the first look, diphtheria, a closer examination revealed the double malady of 
follicular tonsilitis and rhinitis fibrinosa. Both affections simulate diphtheria almost 
to delusion. The clinical picture of a grave constitutional disease, high fever, etc., 
which symptoms are a conditio sine qua non for a diagnosis of true diphtheria, were 
absent. On the other hand some authors have lately classified rhinitis fibrinosa with 
diphtheria, but the best authorities in the old and new world strongly object to such 
classification. The argument that if the Klebs-Lceffler bacillus be found, the case 
must necessarily be one of true diphtheria, does not always hold good, as Baginsky and 
others have found the same baoillus in different forms of rhinitis and pharyngitis. 
While I must admit that not every case of diphtheria is associated with a high temper- 
ature, constitutional depression, etc., such is the rule without any exception in nasal 
diphtheria. After nose and throat have been sprayed with hydrozone there could be 
found no microbe in the culture taken the other day. 

The number of cases of this kind which I have successfully treated approaches 
closely to one hundred. If, according to the Board of Heakh of New York, Chicago 
and other institutions, they ought to be styled diphtheria, well then what is the use of 
injecting blood serum taken from some animal ? We have in hydrozone (30 volumes 
aqueous solution of anhydrous peroxide of hydrogen) a remedy which not only kills 
instantaneously the Lceffier bacilli, but also changes chemically the soil in which their 
spores can develop. Its deadly action is limited to vegetable cells (pathogenic germs) 
and it is the most powerful stimulant to healthy granulations, having no injurious action 
upon healthy animal cells. In fact, my experiment taught me that hydrozone is a safe 
and most reliable remedy to use in the treatment of diphtheria. On the contrary, I 
will say: 

How can we rely upon antitoxin ? 

203 E. Columbia Street. 



HYDROZONE IN PURULENT OTITIS MEDIA. 

By WM. CLARENCE BOTELER, M. D., of Kansas City, Mo. 

A Report of a Case Supposed to Involve Inflammation of the Mastoid. 

Published by the Medical Bulletin, of Philadelphia, Pa., February, 1896. 

On November 4, 1895, I was consulted at my office by Robert P , aged 24 

years; occupation, laborer in the Armour Packing Company. The patient complained 
that for about four weeks he had been suffering from intense pain in his left ear, making 
it impossible for him to sleep at night, or rest during the day. The pain was so severe 
that at times he apparently lost consciousness and it seemed to extend through his entire 
brain. Upon inspection, the man's face was found terribly deformed; an edematous 
swelling the size of one half of an ordinary loaf of baker's bread occupied the usual 
location of the ear and the surrounding muscles. The auricle of the ear was almost 
buried in edematous tissue; upon palpation, the part was found intensely tender and 



deep pressure invoked expressions of excruciating pain. The integument and sub- 
cutaneous tissue were thoroughly infiltrated. Ichorous, fetid pus was slowly exuding 
from an almost imperceptible meatus. The patient expressed feelings of chilliness, 
•showing a possible septic contamination of his system. Every indication and sign pointed 
to possible suppuration of the mastoid cells — tenderness upon pressure over the mastoid 
being very marked. Efforts to localize the tenderness, whether in external meatus or 
mastoid, for discriminating diagnosis, were unsatisfactory. I concluded to withhold a 
positive diagnosis as to whether the condition was purulent otitis media or suppurative 
inflammation of the mastoid, and used tentative treatment for a short while. I imme- 
diately placed the patient under heroic doses of elixir of the six iodides internally. After 
laborious effort I succeeded in separating the edematous tissue sufficient to admit the 
introduction of a small Eustachian catheter into the external meatus. Through this, 
with a small hard rubber syringe, I injected four times daily about one-half an ounce of 
hydrozone, allowing it later to drain away, advising hot fomentations. The patient was 
confined to his bed and the best possible hygienic surroundings provided. In twenty-four 
hours after the treatment was commencea, the intensity of the odor, amount and char- 
acter of the discharge had manifestly lessened, the swelling was reducing and the patient 
feeling better. The edema being lessened, the aperture was enlarged. I now recom- 
mended the injection of hydrozone through a catheter of larger calibre, every hour, 
requiring the head to be kept turned to the opposite side for ten minutes to allow the 
percolation of the hydrozone as deeplv as possible into the middle ear, before reversins 
the position to allow drainage. I continued this treatment for a week, the man'g 
recovery progressing with remarkable rapidity, his pain and the constitutional symp- 
toms having disappeared about the third day. At the end of eight days the swelling had 
entirely disappeared, his features were again normal, and he expressed himself as per- 
fectly well. An examination showed a circular perforation in the ear drum the size of 
a shot, proving that the case had been one of purulent otitis media, with septic con- 
tamination of the patient's system, and infiltration of the surrounding cutaneous tissues. 
Small incisions were made at two different places to permit the exit of pus from the 
integument. The mastoid was found not involved. The rapidity with which the dis- 
ease yielded after the introduction of hydrozone through the catheter into the middle 
ear impressed me with the wonderful value of the preparation; for struggling with such 
cases during a practice of seventeen years, I have never seen ifs efficiency equalled by 
any medicinal or operative procedures. 



PEROXIDE OF HYDROGEN. 

By WARREN BROWN; M. 1)., Tacoma, Wash. 

Published by The Medical Sentinel, of Portland Ore., February, 1896. 

(Read before the Washington State Medical Society, May 1805.) 

This is usually made by the decomposition of hydrated peroxide of barium by sul- 
phuric acid. It is employed in the arts for bleaching. The usual commercial article 
yields about ten volumes of oxygen. 

Dr. Benjamin Ward Richardson, the famous London physician, who in 1893 
received knighthood from Queen Victoria, first experimented with Peroxide of Hydrogen 
in 1857. It was regarded then as a curiosity, and was soon forgotten. Thirty years 
later, Dr. Squibb, of Brooklyn, brought it prominently before the profession, and since 
that time it has been used more and more each year, until its consumption has reached 
enormous proportions. 

In order to preserve hydrogen peroxide it must be slightly acid; on this account, a 
disagreeable irritation and smarting may be caused by its use on mucous membranes. 



213 

This can be avoided by mixing it fresh at the time it is to be used with equal parts of 
lime water, or spraying with lime water first. 

It effervesces not only with pus, but with blood, serum, mucus and cerumen: It 
is one of our best antiseptics, and it is of the greatest value in removing septic clots 
and enveloping fluids before making applications of other drugs. 

As a bleaching agent, in skin practice, it is constantly used in removing pigmen- 
tary stains, and may always be tried before resorting to bichloride of mercury in the 
treatment of freckles and chloasma. Discolorations of the skin and nails caused by the 
aniline dyes, chrysarobin, pyrogallol, sulphur, and permanganate of potash will yield to 
this excellent bleaching agent. Nearly all of the patent hair bleaches on the market 
contain peroxide of hydrogen. 

Gonorrhoea may often be aborted by using a full strength hydrogen dioxide injec- 
tion immediately on the very first appearance of discharge. The meatus should be 
closed and the solution retained for five minutes. The injection should be used four to 
six times in twenty-four hours. This drug is only of value in the incipient stage. 

Cystitis, where pus is voided with the urine, often yields rapidly to injections of a 
solution containing two ounces to the pint. 

Otitis media is treated by hydrogen dioxide solutions in various strengths from 6 
per cent, upward. It is an almost indispensable agent in these cases. 

Eye diseases, where there is a purulent external inflammation, are constantly being 
benefited by this agent. The Wills Eye Hospital, Philadelphia, uses a 50 per cent, 
strength^ f the so-called 15 volume solution. Blepharitis marginalis is quickly cured 
by touching the edges of the lids once or twice daily with a strong solution, care being 
taken to avoid getting it into the eye. 

Ulcers of all kinds improve rapidly under its use, granulations are stimulated and 
surfaces freshened. For treating and cleansing venereal sores, as chancroids, etc., it 
is of great service. 

Empyema, especially where there is from the first a stinking, sanious exudation 
following incision, is very satisfactorily treated by washing out the cavity with a solu- 
tion from one-half to full strength. 

Dr. Xoble, of Philadelphia, commends this agent for cleansing the hands prepara- 
tory to abdominal operations when the skin about the nails has become horny and rough 
from frequent contact with antiseptic solutions. 

In appendicitis, the abscess cavity is cleansed with this solution by many operators, 
in preference to any other antiseptic. Dr. Robert T. Morris, of New York, has laid 
■special stress on the value of the peroxide in these cases. 

In follicular tonsilitis, the use of a spray, diluted just enough to prevent the 
smarting sensation, and alternating with this, one of the alkaline antiseptic sprays, or 
gargles, is a very satisfactory procedure. 

Diphtheria and all naso-pharyngeal inflammations where there is a pseudo-mem- 
branous and septic condition, have been treated very widely bv means of this agent. I 
like the plan of Jennings, in Detroit, who uses an irrigation of an aqueous solution of 
one eighth each of hydrogen dioxide and listerine. He throws the solution into the 
pharynx with an all-soft rubber syringe every one, two or three hours. The plan is an 
admirable one for treating children, and the combination is pleasant and effective. 

Atrophic rhinitis is benefited remarkably by the use of a 40 per cent, spray. It 
should be used a few minutes before the employment of the usual alkaline, stimulating 
spray, and the powder insufflations. In this way the scabs are loosened, muco-puru- 
lent secretions are dissolved, and a stinking breath is converted into one that is pure 
and sweet. 

In acute cases of eczema of the leg, we find this agent of the utmost value. The 
tissues are inflamed, hot, swollen and oozing, the itching is almost unendurable, the 
odor is offensive. To secure the best results the limb is elevated, and a diluted solu- 
tion of the peroxide is applied frequently, with cheese-cloth, gauze or an atomizer. 
In two or three days a marked change for the betti-r will be apparent, the pruritus j s 



214 

allayed, the purulent exudation is checked, and all inflammatory symptoms are sub- 
siding. At this stage we begin the use of a soothing ointment, such as the boracic 
acid or zinc oxide, using lime liniment to wash the parts instead of water. Under this 
treatment, combined with rest, we will see our patient rapidly cured. 

Eczema of the anus will rapidly improve if the fissures are touched twice a day 
with this solution, then dried gently with cotton, and a glycerite of lead application 
made. In nearly every form of acute eczema in the first and second stages the per- 
oxide will give us the keenest satisfaction. The regular solution is diluted with two or 
more parts of water. Hydrogen peroxide is an excellent anti-pruritic, and for this pur- 
pose it is widely used. 

The haemostatic value of this drug, as pointed out by Dr. Emerson Brewer, of 
New York, I can endorse. In operations on the nose and throat I have upon two 
occasions been enabled to check a persistent hemorrhage, when Monsel's solution and 
plugging had failed. At present I am in the habit of applying the full strength hydro- 
gen dioxide after every operation on these parts. It is of special value after sawing out 
a deviated septum. 

For flushing out a mammary abscess cavity this agent is invaluable. 

Applied to cervix uteri, adherent mucus is removed and our medications can be 
applied. 

Where it is inadvisable or impossible to make a complete opening of a fissure or 
abscess, irrigation with the peroxide will be found superior to all other antiseptics. 

We have in Peroxide of Hydrogen a prompt, safe and efficient germicide. By its 
oxidizing power it rapidly decomposes pus, diphtheritic membranes, and other morbid 
putrifying material. It is a thorough deodorizer, and as a cleansing agent for foul 
wounds, abscesses, etc., it has no equal. 

Of the different preparations of peroxide, Marchand's has been most uniformly 
satisfactory. 

Bibliography. — Piffard, Jennings, J. Lewis Smith, Noble, Morris and others, as well as the cur- 
rent medical journals. 

Since writing the foregoing paper my attention has been called 
to Hydrozone, a stronger solution of Peroxide of Hydrogen, which 
for some months I have been using with much satisfaction. 



CHRONIC GASTRITIS OF LONG STANDING, WITH 
PERIODIC ATTACKS OF MIGRAINE. 

By GEO. A. CURRIDEN, M. D., of Chambersburg, Pa. 

Published by the Medical Summary, of Philadelphia, Pa., March, 1S96. 

The herewith reported case is one of double interest inasmuch as the patient has 
been under my care for a number of years, and previous to the commencement of the 
present treatment, I have been unsuccessful in affording much relief or preventing the 
recurrence of the frequent and periodic attacks of migraine, to which she had been 
more or less subject to since early womanhood. The cause of which I could not 
account for more that "a habit long continued," aggravated by gastric catarrh. 

The history of the case is briefly as follows: Mrs. A., aged 55, since early 
womanhood has been subject to periodic attacks of migraine at intervals of two, three 
or four weeks, but seldom free from them for longer intervals. 

An attack comes on by general malaise of usually a day's duration, repugnance of 
food or drink, marked drowsiness, much depression with request for rest and quiet, 
followed by complete physical prostration, dull frontal headache, which the least noise 



215 

or disturbance makes the more intense, invariably accompanied by violent and frequent 
attacks of vomiting and retching, inability to retain any food or nourishment of any 
kind, retention of bowels, often cold sweats, pulse somewhat slow and weak and small 
in volume. This condition lasting usually two days, followed by gradual cessation of 
symptoms. 

During the whole period of usually four or five day's duration, she is unable to 
take nourishment of any kind, remains constantly in bed, and desires only complete 
rest and quiet. The previous treatment has been so varied and on so many different 
plans, that I refrain from mentioning them. 

Two years ago I was able to prevent an attack for over two months by the use of 
strychnine in 1-20 grain doses t. i. d. with careful diet and artificial digestives. 

In May, 1S95, I put her on Charles Marchand's "Glycozone" treatment in teaspoon- 
ful doses well diluted t. i. d. using this as all other previous remedies experimentally; 
she commenced to improve much in general health, an unusually good appetite, without 
the previous distressing symptoms following, a more regular movement of the bowels, 
freedom from headache and in every way a decided improvement; this improvement 
and enjoyment of good health lasted during continuation of above treatment for over 
three months. Unknown to me she stopped taking the Glycozone, thinking herself 
perfectly well. In a few weeks had a return attack, milder and devoid of gastric dis- 
tress. A similar attack two months later, both of which occured some weeks after 
stopping of the above described treatment, and I might say caused by imprudence in diet. 

The conclusion come to, in this case, is that the headache is sympathetic, that the 
stomach becomes acutely inflamed by its inability to naturally and properly perform its 
functions, and responds to the call of nature to unload itself, and thus secure for a time 
rest, that the use of Glycozone has corrected the existing gastritis, and by so doing ha* 
removed the primary causes of these many years of suffering. 



DISEASES OF THE EAR. 

By ALBERT H. BUCK, M D., ok New York City. 
(Abstract from The Journal of Medicine and Science, of Portland, Me., March, 1S96. 

When it was announced that Dr. Buck would write on "Diseases of the Ear," in 
the Twentieth Century Practice of Medicine, it was a guarantee that affections of the 
ear would receive the attention their importance merits, for he has been long and favor- 
ably known as a writer and teacher of the highest attainments in the department of 
otology which he has made his life study. 

We are pleased to notice Dr. Buck's reference to the value of peroxide of hydrogen* 
in the treatment, particularly of chronic suppurative inflammation of the middle ear. 
He says: "To this drug more than to any other is due the credit for scores of cures 
which nothing short of a radical operation could otherwise have effected," which cer- 
tainly is of the highest importance for every physician to know, especially if he can learn 
to use a drug the proper use of which will do away with an operation that he can not 
do. 

In the selection of such a valuable remedy it is of the highest importance to obtain 
a reliable one and in this respect while there may be the product of other manufacturers 
in the market that is reliable, we have come to think of Marchand's, when ordering it, 
the same as we do of Squibb's ether when ordering an anaesthetic. 

*Hydrozone (30 volumes H2 O2 aqueous solution) will give better results in all cases, on account 
of its healing and bactericide properties which are far superior. See article headed: "Hydrozone in 
Purulent Otitis Media," p. 210. 



2l6 

HYDROZONE IN GASTRIC AND INTESTINAL DISORDERS. 

By JOHN AULDE, M. D., Philadelphia, Pa. 

(Published by the New York Medical Journal, August 15th, 1896.) 

A period of nearly twelve years has elapsed since I first began the clinical use of 
hydrogen dioxide, generally referred to at the time as the peroxide of hydrogen. In 
1887 I published a paper giving a detailed account of several cases in which it had been 
employed by inhalation, but even then I was thirty years behind the report of Dr. (now 
Sir) Benjamin Ward Richardson, of London, who had made a thorough investigation of 
its antiseptic, detergent, and healing properties. Notwithstanding the fact that this 
preparation has been known to the medical profession for that length of time it had 
achieved little or no reputation. This, however, may be explained by the fact that the 
discovery preceded the dawn of bacteriology. Indeed, I was one of the early contribu- 
tors to medical literature relating to the clinical value of this product, and since that 
time I have published a number of articles, embracing practically every application, 
both medical and surgical, to which hydrogen dioxide is adapted. 

In the present communication it is my object to direct the attention of the profes- 
sion to its special value in the treatment of gastric and intestinal disorders. In gastritis, 
for example, there is no antiseptic which can be given with so much benefit as this rem- 
edy, because its effect is immediate, and even in considerable doses it is absolutely harm- 
less. The same is true in regard to itsemployment in typhoid fever, cholera infantum, 
and Asiatic cholera. In the latter disease its efficacy has been thoroughly demonstrated 
by a number of well-known physicians, and its applicability in cholera infantum is well- 
known to those physicians who have given careful attention to the most modern 
methods in the treatment of this class of cases. 

The following brief notes will be sufficient to indicate the availability of this rem- 
edy in the treatment of the disorders already mentioned, although, in view of the fact 
that hydrozone is a more concentrated product, and withall a permanent solution, this 
latter remedy should have the preference. It contains at least double the volume of 
nascent oxygen which has heretofore been the standard for the medicinal peroxide of 
hydrogen. 

In gastritis, either acute, subacute, or chronic, we have to deal with an unhealthy 
condition of the lining membrane of the stomach. The inflammation is attended with 
an increased output of mucus, which seriously interferes with the normal functions of 
the peptic glands. By the introduction of a small quantity of hydrozone, in the strength 
of one part to thirty-two parts of boiled or sterilized water, this objectionable mucus 
is at once destroyed by the action of the oxygen which is released, and the contents of 
the stomach remaining are promptly discharged into the small intestine. A patient suf- 
fering from gastritis should take at least half an hour before meals from two to four 
ounces of diluted hydrozone (one to thirty-two) and lie on the right side so as to 
facilitate the action of the stomach in discharging its contents*. The antiseptic prop- 
erties of hydrozone thus used are sufficient to destroy the micro-organisms and leave 
the stomach in a healthy condition for the absorption of nutritive pabulum. All forms 
of fermentation are promptly subdued by the active oxidation resulting from the libera- 
tion of nascent oxygen. The patient is then in a condition to take suitable food, which 
should be nutritious and easily digested, liquids being preferred until the active symp- 
toms have subsided. Later small portions of solid food can be ingested, but all food 

* In chronic cases with a large output of gastric mucous, and particularly in gastric 
ulcer concentrated solutions are not well borne at first, owing to the formation of oxy- 
gen gas, but this difficulty disappears with the continuous use of the remedy, and no 
treatment of gastric ulcer can be regarded as complete without the local employment of 
hydrozone. 



stuffs of a starchy character must be thoroughly masticated, in order to secure the action 
of the salivary secretion upon the starch granules, breaking them up, and lessening the 
tendency to fermentation in the stomach. After taking a meal, a patient with gastritis 
should follow it with medicinal doses of glycozone, which contain, in addition to the 
nascent oxygen contained in hydrozone, a percentage of glycerin, which favors osmosis 
and assists in re-establishing the functional activity of both the peptic and mucous glands 
of. the organ. 

In the treatment of cholera infantum, typhoid fever, and Asiatic cholera, the same 
general plan should be adopted in dealing with the stomach, always bearing in 
mind the necessity for having the patient remain in the recumbent position and on the 
right side for at least half an hour after the ingestion of the solution. In addition, how- 
ever, to the preliminary treatment of the stomach, the same solution (one to thirty- 
two) is used as an injection into the lower bowel, care being exercised to insure its intro- 
duction as high up as possible. This can be managed by having the patient lie on the 
left side, with the hips well elevated, and the employment of along, flexible rectal tube. 
In this manner we secure and maintain an antiseptic condition in both the stomach and 
large intestine, the importance of which will be understood when we consider the large 
number of micro organisms which grow under these favorable conditions with such 
remarkable rapidity. 

When deemed advisable, the solution introduced into the lower bowel may be com- 
bined with large quantities of either hot or cold water, which enables us to obtain the 
benefits of irrigation in addition to antiseptic effects. These irrigations may be em- 
ployed as frequently as deemed advisable by the medical attendant, but they will 
usually prove satisfactory if administered at intervals of four hours. 

Although brief, it is believed this communication will prove serviceable to a large 
number of practitioners who have hitherto found serious difficulties in counteracting the 
mephitic influences of bacteria in this class of disorders, and the clinical virtues of the 
remedy being now so fully recognized, no one will hesitate to adopt the methods 
suggested, which may be conveniently carried out in addition to the usual routine 
treatment. 



TREATMENT OF INFLAMMATORY DISEASES OF THE 

STOMACH.* 

By GUSTAVUS M. BLECH A. B., M. D., Detroit, Mich. 

Published by The Mathews' Quarterly, October, 1896. 

For several years I have had under my care quite a number of patients afflicted 
with acute or chronic inflammatory diseases of the gastro-intestinal tract. The records 
of my clinic (143 of such cases) show that stomcch diseases are to my knowledge the 
most distressing ailments which may afflict human beings. When the stomach is out 
of order life is a burden and everything seems to go wrong. 

The majority of general practitioners, as far as I could learn, still adhere to the 
old-fashioned treatment of gastric disorders, and I confess that during the first years of 
my practicing medicine I have, like others, .used remedies which every one of us have 
prescribed, in order to relieve their patients, and to my great disappointment I never 
was fortunate enough to cure chronic gastritis by treating the symptoms, although I 
have occasionally relieved my patients, but only when the disease was not chronic. 

You have — as well as myself — prescribed menthol, cocaine, opium, ice, and other 
remedies to relieve nausea and to stop vomiting; you have cleansed the stomach by 

♦Read before the Mississippi Valley Medical Association at St. Paul, Minn., September 16, i8q6. 



218 

lavage and purgatives, and subsequently irrigated the lining membrane of that much 
abused viscus with modern antiseptics; you have called to assistance pepsin and 
innumerable drugs, but have you cured your patient? No. You have merely lost track 
of him. The patient did not call again, because the treatment did not do him any 
good, and frequently because it aggravated his trouble. 

So the world goes on and the poor creature afflicted with chronic gastritis goes on 
suffering more and more. Why did you fail to cure catarrh of the stomach ? It is 
because you merely attempted to relieve the symptoms instead of prescribing remedies 
to subdue the existing pathological condition, the inflammation of the lining membrane 
of the stomach, which condition prevents the digestive process from being normal. 

In order to subdue this abnormal inflammatory condition of the wall of the stom- 
ach antiseptics are indicated, but you know as well as I do that powerful antiseptics 
have the same destructive action upon both vegetable cells (germs) and animal cells. 
Consequently, they will in all cases aggravate the disease. 

I am much opposed to the use of strong drugs in my practice on account of sad 
results which I have witnessed, and I put more stress on harmless, although most 
powerful antiseptics, than I ever did since I successfully treated hopeless cases of 
cholera infantum with hydrozone (30 vols. H 2 2 , aqueous solution). 

Therefore my method of treatment of all inflammatory diseases of the stomach may 
be summed up as follows: First destroy the morbid element which is present in the 
stomach, so as to thoroughly cleanse the mucous membrane; second, heal the diseased 
surface after it has been made aseptic. 

As a cleansing agent which acts both mechanically and chemically, I know of 
nothing as powerful as hydrozone. Therefore I prescribe one tumblerful of lukewarm 
water containing two percent, of hydrozone, half an hour or so before meals. 

The nascent oxygen which is set free in the stomach by its oxydizing action destroys 
the morbid element and cleanses the mucous membrane more thoroughly than anything 
I know of. This being done, the patient should wait for at least fifteen minutes before 
taking his meal. 

As a healing agent I prescribe one to two teaspoonfuls of glycozone diluted in 
water to be taken immediately after meals. 

The results which I obtained in submitting my patients to the above rational treat- 
ment are so gratifying that I do not hesitate to say here that the great majority of 
cases of stomach disorders may be cured or at least much relieved in a very short time 
by this treatment, which is already indorsed and used by some of our most skillful 
practitioners. 

On this occasion I wish to state that I cured a well-defined case of gastric ulcer, 
at least all the characteristic symptoms, like circumscribed pain, indigestion, and hema- 
temesis have disappeared for fifteen months under the above treatment, save lavage, 
which when practiced once caused an alarming hemorrhage. I wrote to the patient, 
who lives in vSt. Louis, and he informs me that neither of his symptoms have appeared 
since I left that city, which was about fifteen months ago. The patient has been 
instructed to resume the treatment as soon as even the mildest symptoms reappear, but 
he wrote me that he needed to use no medicine whatever. 

While my experience with gastric ulcer is but limited, I could suggest no better 
treatment; first, because all usual remedies do not influence the ulcer itself, and second, 
because I have seen healed the most stubborn cases of ulceration of the cervix and 
chronic ulcers of the leg under the same method of treatment. 

During the discussion which followed the reading of this paper, Dr. Larrabee, of 
Louisvilie, had this to say: Almost any condition found in the stomach may come 
from the causes mentioned by those who have spoken, but I am convinced that the 
portal circulation is a most important factor in these cases; and one, too, which is often 
overlooked. Exercise is of paramount importance, in all cases of chronic gastritis. In 
arresting /w//v/ ^active changes in the stomach glycozone has proven in my hands most 
excellent, but do not neglect to stimulate the liver when indicated. 



219 

TREATMENT IN DIPHTHERIA. ' 

By E. LAWRENCE LINDER, M. D., Blackfoot, Tex. 

(Published by the. Medical Brief, St. Louis, Mo., October. 1896.) 

Much has been written about diphtheria and its treatment in the Brief, but I will 
add my mite, thinking it will be of some benefit to my professional brothers. 

In the beginning, I will state that I have used antitoxin in three cases, and two 
proved fatal. I will never use it again, unless forced to through the solicitation of the 
patient's family, 

I will give my experience in the treatment of three cases of diphtheria: 
Case i. — In June 16, I was called to see H. R., a girl eight years old, and found 
her suffering with diphtheria. I at once prescribed mild chloride of mercury in two 
grain doses every two hours, until the bowels moved freely. At the same time I painted 
throat externally and internally with tincture iodine. I also ordered the throat to be 
sprayed with the following every two hours: 

1$ Peroxide of hydrogen (Marchand's,) § j. 
Aquae dest., f vij. 
On the 17th, I found patient about the same as on the previous day; the bowels 
having acted well, but not too much. I then put the patient upon following treatment: 
B/ Potassii chloratis, 3 j. 
Aquae dest., § j. 
Mix and give one drachm every two hours, also adding to each dose five drops of 
the tincture of iron. 

For the throat, I used ihe following solution with an atomizer: 

1} Peroxide of Hydrogen, (Marchand's,) § j. 
A^ae dest. 
M. Use every two hours with atomizer. 
Also; 

B; Potassii permanganate, gr. viij. 
Aquae dest., § j. 
M. Use every two hours with atomizer. 
I used the above solutions alternately every hour. 

I continued the above treatment, and on June 22d, I discharged the patient, 
prescribing the following, however, as a tonic to be taken for a week or two. 
B/ Strychnia sulph., gr. j. 
Quiniae sulph., gr. xxxj. 
Tinct. ferri chlor., § j. 
Aquae dest., q. s. ad. § iv. 
M. Sig. One drachm every six hours. 

Case 2. — On June 19th, three days after case one was taken, I was asked to pre- 
scribe for O. R., six years old, a brother of case one. I found the little fellow suffer- 
ing also with diphtheria, and put him on the same treatment as in case one except the 
doses were diminished. The fever being higher than in case one I gave a few doses 
of acetanilid and aconite, until fever was reduced. With the same treatment this child 
recovered also, and on June 27th, I discharged him, leaving the same tonic that I gave 
his sister. 

Case 3. — On July 3d, I was again called to Mr. R.'s, this time to see little G., 
three years old, and a brother to cases one and two. I began treatment as I had 
in the two previous cases. On the 4th and 5th there was little or no change. Mr. R., 
the child's father, having read of antitoxin and its wonderful (?) cures, asked me to use 
it. I at first refused and called in Dr. D. in consultation. After consulting, we agreed 
to use antitoxin; both of us, however, did not wish to use it. On the 6th, the condition 
of the patient unchanged. On the 7th, patient worse, and on the 8th, Dr. D. told the 



220 

family that the patient would die, and discontinued his visits. After much pleading, 
I got the father to permit me to discontinue the antitoxin. I at once resumed former 
treatment, adding to treatment the cauterization of membrane with nitrate of silver, and 
controlling fever with aconite and gelsemium solution, and acetanilid and antikamnia 
powders per rectum. 

On the following day, the 9th, patient was resting easier, breathing freer, and 
condition somewhat improved. This improvement continued until the 16th, when I 
discharged the patient, leaving the following tonic to be taken for two or three weeks: 

1$ Quiniae bisulph., gr. x. 
Strychnia, sulph., gr. £. 
Nitro-hydrochloric acid, gr. xxx. 
Tinct. iron, 3 iiss. 
Aquae dest., q. s. ad § viij. 
M. Sig. One teaspoonful every six hours. 

The patient continued to improve, and on July 27th, came into my office with 
his father, looking well and healthy. 

From my experience with these three cases, and especially the last one, I must 
confess that I have no faith whatever in this new fad called antitoxin. I will never 
use it again. 



A CASE OF PROTRACTED LABOR. 

Rupture of the Uterine Wall — Concealed Hemorrhage — Subsequent 
Extensive Sepsis and Mural Abscess, etc., Ending in Recovery. 

By J. N. UPSHUR, M. D., Richmond, Va. 

Professor Practice of Medicine, Me'dical College of Virginia. 

Read before the Richmond Academy of Medicine and Surgery at a meeting held 

October 13, 1896. 

Dr. LANDON B. EDWARDS, President, in the Chair. 

Dr. MARK W. PEYSER, Secretary and Reporter. 

Published by the Virginia Medical Semi-Monthly of Richmond, Va., for Oct. 23, 1896. 

Mrs. H., jet. 40, of good health prior to two months before delivery, when she 
had an attack of dysentery. I saw her at that time. She had a recurrence of the 
attack twice, but treated herself with the same remedies prescribed by me during the 
first attack. With this exception, her pregnancy had been an uneventful one. 

Labor came on suddenly at 7 p. m., September nth— pains so active and strong 
that I was twice sent for within an hour. When I reached my patient at 8 p. m., she 
looked pallid and showed evidence of extreme suffering— pains were strong and regu- 
lar, coming on every few minutes. Digital examination revealed a cervix very rigid, 



thick, and about two inches long, through which could be felt the vertex presenting in 
the first position. The pains, though violent and causing much suffering, made little 
impression in dilating the rigid cervix. To procure rest and relaxation of the cervix, 
about 12 p. m. I administered a hypodermic of sulphate morphia grain one-fourth, 
sulphate atropice, grain yA^. This procured her some respite from suffering for three 
hours, when pains again became active. Cervix had slightly softened. She was now 
given chloroform, but only with the effect of stopping pains. A second hypodermic 
was given at 7 a. m., and I left the patient for three hours. 

On my return at n a. m., I found cervix relaxed and dilatable, and pains active 
and regular. Patient looked pallid, with feeble pulse, and had clammy skin. But 
that she had had three exhaustive attacks of bowel trouble and a wearing labor from 
the beginning, I should have suspected concealed haemorrhage. Chloroform was again 
administered, and she was normally delivered at 12:45 of a still-born male infant weigh- 
ing nine pounds. She had last felt the motion of the child just prior to the onset of 
labor. There was delay in che delivery of the placenta, and the uterus was in a state 
of complete inertia. Examination showed the placenta detached, and it was easily 
removed ; introduction of the hand being followed on delivery by a double handful of 
coagula. It was evident that partial detachment of the placenta had taken place prior 
to the birth of the child. 

The uterus remaining obstinately relaxed, the hand was passed into the cavity, 
which presented a feeling of a ragged bag, while on the right of the uterine wall, half 
way between its anterior and lateral portion, could be felt an incomplete rupture of the 
uterine wall in its long diameter about three inches long, and extending four-fifths of 
the thickness of the uterine wall, so that a narrow escape had been made from opening 
the peritoneal cavity. After administration of sulphate strychnia grains ^, and fluid 
extract ergot (Squibbs) 3 v, with introduction of ice into the cavity, the womb was 
induced to contract finally. I would have preferred a hot salt solution, but it was not 
available, and only a septic syringe with which to use it, if it had been. The patient 
reacted well. Having always had a free secretion of milk, tincture of camphor was 
ordered applied to the breasts, beginning a few days after delivery, extending its appli- 
cation well into the axillae. This proved efficient, and no milk was secreted. 

On the second and third days after delivery, temperature only rose to 99. 4 F. 
On fourth day it reached ioo = F. Lochia profuse, offensive, of the color of dirty dish 
water. Free hot douche of hot water and borax was ordered thrice daily. 

But on the morning of the fifth day, finding no improvement except temperature 
slightly subnormal (98° F.), the uterus was washed out freely with hot salt solution. 
Uterus was found above the pubis, and spongy. Ordered tincture chloride iron, ergot 
and nux vomica in full doses every four hours. 

On sixth day found little change in lochia, and that seventeen napkins had been 
used in previous twenty-four hours; pulse fair at 90-100; temperature as on day 
before. Curette (sharp) was used, and a number of dirty shreds of sloughing tissue 
were removed. 

On seventh day, patient expressed herself as feeling better; pulse and temperature 
same as on day previous. Curette was again used, and large pieces of sloughing (issue 
were removed; curette gave way suddenly, giving sensation of entering a cavity, and 
was followed by a discharge of an ounce or more of thick, dirty-colored stinking pus. 
I believe the rupture had healed on the surface, and an abscess had developed at the 
bottom. The curette was freely used until discharge was slightly stained with blood. 
Half gallon of salt solution was run through the uterine cavity till it came away clear 
and odorless; patient expressed herself as feeling much more comfortable. 

On eighth day, pulse and temperature same; ten napkins used; curette again 
applied; no shreds. Washed out with Peroxide of Hydrogen, followed by salt solution, 
and lightly packed with iodoform gauze. 

Twenty-four hours after delivery, the patient complained of severe headache, 
located chiefly in the occiput. This was relieved by two doses of phenacetin of gr. v. 



222 

each, but returned when the drug wore off. Subsequently benefited by sodii bromidi 
gr. xx, and caffeine gr. ss. Patient had a comfortable night, has some appetite, 
expressed herself as free from headache, and feeling much better; said headache 
returned after treatment of womb. She has taken on two days full doses of quinine, 
but I could detect no benefit from its exhibition. Bowels have been moved on alternate 
days by exhibition of compound senna powder. Tongue has been clean, but pallid 
from beginning. 

On ninth day, eleven napkins in last twenty-four hours; temperature, ioo° F.; 
pulse, 108; had a good night, but sweated freely; appetite fair; discharge very little 
offensive; curette used; § j of pus discharged from uterine cavity; came from site of 
rupture; uterus reduced decidedly in size; washed out freely with Peroxide of Hydro- 
gen, one-fourth to three-fourths hot water, followed by salt solution. Patient complained 
of violent frontal headache during the dressing, which passed off when completed; 
light packing of iodoform gauze applied. 

Tenth day, eight napkins; pulse, ioo; temperature, 99.4°; no odor in discharge; on 
removing gauze, f ss pus flowed away; uterus cannot be felt above pubis; measured 
three inches with probe; swabbed out with pure peroxide and replaced with gauze; com- 
plained of severe frontal headache during the dressing, which subsided when it was 
completed. 

Eleventh day, five napkins; temperature, 99. 2°; pulse, 100; on removing gauze 3 ss 
pus; no sweating. 

Thirteenth day, temperature, 99.4. pulse 100; no sweating. 

Fourteenth day, pulse, 96; temperature, 99°F,; no flow. 

Sixteenth day, pulse, 100; temperature 97.0 5 ; convalescence established; patient 
sat up an hour and a quarter. 

Twenty-eighth day, patient dressed and moving about her room; says she is abso- 
lutely comfortable; no pain or weakness in back or elsewhere, except a little unsteady 
on her feet. 

Remarks. — The above case presents first in interest, the condition of the cervix at 
the beginning of labor, so hard and resistant as to give the impression of previous dis- 
ease, which had not been the case, except a slight cervical catarrh, for which I had 
treated her prior to her sixth confinement, which had been rapid and uneventful. Pains 
seemed absolutely inefficient in producing dilatation until after the administration of 
morphine — the resistance in spite of such strong contractions being responsible for the 
subsequent complications. I am sure that ihe patient's pallor was due to concealed 
haemorrhage from premature partial separation of the placenta, not appreciated at the 
time because of my knowledge of three attacks of dysentery in the previous two months 
and the suffering she had borne incident to the violent uterine action, ineffective and 
depressant. The inertia of the womb was simply muscular tire. 

The rupture of the uterine wall in its long axis is of interest, because the almost 
invariable rule is that when rupture occurs, it is in the transverse direction. "Koudl 
reported nineteen cases in 40,614 labors occurring in nine years in the Lying-in Hos- 
pital in Vienna. Jolly, in Paris, found 230 cases in 782,741, excluding from his list 
lacerations of the cervix. Harris estimated one case in 4,000 labors. Lusk found 
forty-seven deaths from this cause in New York between 1867 and 1875, inclusive, or 
one death in six thousand labors." — (Lusk's Obstetrics, page 603.) I had a case of 
complete rupture due to after-coming hydrocephalic head — patient dying five hours 
after delivery. 

Hagenberger estimated the mortality at 95 per cent. ; C. Braun at 89 per cent. (Lusk, 
page 603.) The above facts show how rare is this complication, even though incomplete. 

Another point of interest is the prevention absolutely of the milk formation by the 
early and repeated use of tincture of camphor in a woman who had in six previous con- 
finements had an abundance. A long experience has proven no remedy better than the 
camphor in my hands. The fact that only twice did the temperature reach too F. in a 
uterus so septic as I have described, is remarkable, and the efficient action in the direc- 



223 

tion of cure of free curettage, douching with salt solution and application of Hydrogen 
Peroxide in stopping suppuration, evidences the great'value of this therapeutic method. 
The violent reflex headache coming on during the dressing and disappearing when it 
was completed, is of interest, and shows plainly that the violent headache coming on 
twenty-four hours after labor, was also reflex in character. 

I deem myself most fortunate to have had such a satisfactory result in this case, 
and place it on record for the instruction and encouragement of my professional 
brethren. 

DISCUSSION. 

Dr. Paulus A. Irving thought it remarkable that there was no hemorrhage from 
the site of the uterine tear. Another striking feature of the case was the low tempera- 
ture in spite of the large amount of pus dammed back — the more remarkable when 
we consider how a little excoriation or tear of the os, or cervix is so often followed by 
a rise of temperature — sometimes even to 104 F. He commended Dr. Upshur for his 
most admirable treatment and successful issue, especially in the employment of Hydro- 
gen Peroxide. Nothing could be added to it. 

Dr. Lewis M. Cowardin called attention to the fact that Hydrogen Peroxide 
affects not only pus, but all organic fluids. Where a blood-clot was to be dissolved, he 
knew of nothing more efficacious. . 

Dr. J. S. Wellford thought Hydrogen Peroxide a better disinfecling agent than 
all others, because it produces super-oxidation of all effete matters, liberating, in the 
body, ozone. In employing it, we imitate the processes of Nature, changing the specific 
character of the ptomaines. 

He asked Dr. Upshur the positions of the placenta and abscess in relation to the 
tear. 

Dr. Arthur Jordan spoke of a case in which he had successfully used creatin, 
bichloride of mercury solution, Hydrogen Dioxide, and Hydr ozone. Hydrogen Dioxide 
had given better results than the first two, but pus was more diminished with two injec- 
tions daily of Hydrozone than three of Plydrogen Dioxide. 

The President stated that in his practice a vaginal douche of Hydrozoize (Marchand) 
prevented the third day fever of the puerperal state. His experience with that of Drs. 
Irving H. M. Taylor, Edward McGuire, and others, in some cases of puerperal sepsis, 
had shown the great value of intra uterine injections of Hydrogen Peroxide and Hydro- 
zone — simply keeping the os uteri well dilated so as to give free egress to the foaming 
pus, etc., that pours out. He uses a half pint to a pint each injection — diluted or not 
with water. Marchand's preparations are those upon which he relies. 

Dr. Upshur, in closing the discussion, said the placenta was above and posterior 
to the rupture, the abscess being seated in the bottom of it. 

He has firm convictions with regard to the value of Hydrogen Dioxide. Often the 
efficiency of applications to the cervix, externally, and canal, is lessened by a skin of 
mucus that cannot be wiped away by cotton. In cases of this kind, the dioxide on an 
applicator will dissolve the mucus, allowing the application to come in contact with the 
tissues. 

For cleansing purposes, he preferred a simple solution of Hydrozone or Hydrogen 
Peroxide to the chemical agents, such as bichloride of mercury, carbolic acid, perman- 
ganate of potassium, etc. 

The Secretary, Dr. Mark W. Peyser, reported a case of horse-shoe fistula success- 
fully treated ivith Hydrozone. Girl, aged 16 years. An abscess developed on either 
side and above the anus, which were on the point of rupturing. Both were incised, 
and afterward injected with Hydrozone until the discharges came away clear. The 
solution made its way from one opening to the other, demonstrating the presence of a 
horse-shoe fistula. In a week it was in a fair way to recovery. 



224 

THE USE OF PEROXIDE OF HYDROGEN IN DISEASES OF 
THE NOSE, THROAT AND EAR.* 

By W. SCHEPPEGRELL, A. M., M D., New Orleans, La. 

Professor of the Ear, Nose and Throat Department of the National College of Electro- 
Therapeutics; Vice-President of the American Laryngological. Rhinological 
and Otological Society, etc. 

Published by Medical Record, Aug. 8, 1896. 

Peroxide of Hydrogen is one of the most useful agents which we have in the treat- 
ment of diseases of the nose, throat and ear; its germicidal and antiseptic properties, 
and its capacity for destroying pus and decaying organic matter, without injurious 
effect on healthy tissues, renders it almost indispensable in many cases. It has always 
been a source of surprise to me, that so little reference to this valuable agent is found 
in the foreign periodicals. 

Peroxide of Hydrogen is not toxic, in fact it is used for internal medication, and 
the amount which may be taken without injurious effect, is well illustrated by a case 
recently reported, in a course of discussion on diphtheria, by Dr. Rudolph Matas. In this 
case, in which Dr. Matas had occasion to prescribe it for a man suffering from asthma, 
the patient, from a misunderstanding of the directions, took six or eight four ounce 
bottles of Peroxide of Hydrogen during one night, and was not only not injured by 
this excessive amount, but actually believed that he had been benefited. 

In the disease of the nose, Peroxide of Hydrogen is an important therapeutic agent. 
In ozena awash of a 25 per cent, solution is useful; or, after washing the nostrils with 
an alkaline or the normal physiological salt solution, the Hydrogen Peroxide, pure or 
mixed with an equal quantity of glycerine, may be applied locally by means of an 
atomizer or applicator with cotton, to remove or destroy any scabs or secretion which 
may be left. In this way the nostrils can be kept clean, and the offensive odor which 
is one of the most unpleasant features of this disease, may be prevented. In purulent 
rhinitis, a 5 per cent, solution, to which an alkaline has been added, is useful, ft is also 
said to be very serviceable in controlling nasal and pharyngeal hemorrhage. 

In membranous rhinitis, whether due to Klebs-La-fner bacillus or to micro-cocci, 
the spraying of the nostrils with a 20 to 50 per cent, solutionis indicated, and has given 
me excellent results. My experience in diphtheritic rhinitis with this agent has been 
so satisfactory that I have not deemed it necessary to use the antitoxin in these cases, 
as this does not seem to prevent the post-diphtheritic paralysis, which would be the 
only reason for my using it in diphtheritic rhinitis. 

In the specific necrosis in the nostrils, Peroxide of Hydrogen is an important agent, 
not only for its disinfecting properties, but also for controlling the horrible odor that is 
present in these cases. In diseases of the accessoty sinuses of the nose. Peroxide of 
Hydrogen is so beneficial that I use it in all cases, whether of a maxillary, frontal, ethy- 
moidal or sphenoidal sinus. In my opinion it cleans and disinfects the infractuosities 
of these cavities more effectively than any other agent that we have. 

In diseases of the throat, Peroxide of Hydrogen is used in follicular and other 
forms of tonsillitis, and in specific affections, and is a sheet anchor in diphtheritic pro- 
cesses in this region. Long before the introduction of antitoxin, I have had excellent 
results from Hydrogen Peroxide in diphtheria, and even since the use of this serum, I 
never fail to use the peroxide as a valuable adjunct; and I believe it to have had an 
important bearing on the results obtained. It attacks the membrane, disinfects the 
parts, and has no injurious effects when swallowed, which is more than can be said of 

The Peroxide of Hydrogen which I use, is made by Charles Marchand, New York, 
and this is the preparation which gave such excellent results in the above case. 



225 

many other antiseptics used for this purpose. In a recent case of laryngeal diphtheria, 
to which I was called in consultation, the stridor and dyspnoea were so marked that I 
was compelled at once to introduce an intubation tube. The tube, however, was 
repeatedly coughed out, and I then made use of a procedure, which I had found bene- 
ficial in former cases, — the injection of a 75 per cent, alkaline solution of Peroxide of 
Hydrogen, directly into the larynx by means of a laryngeal syringe. The relief, given 
by this injection was so great, that I was not compelled to intubate again, but simply 
to make these injections every four hours. The patient also received three injections of 
diphtheria antitoxin serum, which I made at intervals of 24 hours, and the child made 
a good recovery. 

Recently a German author called attention to the irritating effects of Peroxide of 
Hydrogen on the mucous membrane; this effect I have found in none of my cases, 
although this may be due to the fact, that in employing this agent, I make use of 
a small addition of bicarbonate of soda, and that I adjust the strength of the solution 
to the requirements of the case. 

Diseases of the ear offer a good field for the use of Peroxide of Hydrogen. As a 
non-irritating antiseptic wash it is invaluable, as in the various forms of suppuration, 
especially where they are accompanied with a disagreeable odor. In diffuse or circum- 
scribed inflammation of the external canal, Peroxide of Hydrogen is useful after an 
incision has been made, and in suppurative otitis media, especially in neglected cases, 
at 5 to 15 per cent, solution is of great assistance. 

In cases complicated by inflammation of the mastoid cells, especially in the sup- 
purative form, the indication of Peroxide of Hydrogen is clear, although this does not 
prevent the use of iodoform, aristol, and other antiseptic agents. 

In acute cases of purulent otitis media, a 5 per cent, alkaline solution should be 
used, as strong solutions are not necessary, and may be injurious. 

Medical Building. 



PEROXIDE OF HYDROGEN AS A HCEMOSTATIC* 

By M. F. COOMES, A. M., M. D. 

Professor Physiology, Ophthalmology, Otology and Laryngology in the Kentucky School of Medicine. 

Abstract from Louisville Medical Monthly, for September, 1896. 

It is probably not generally known to the profession that Peroxide of Hydrogen is 
a valuable haemostatic. Its contact with blood results in the almost immediate coagu- 
lation, or rather, production of fibrin. Of course this is desirable, as the clot thus 
formed is nature's clot, and not such as produced by the union of blood and Monsell's 
solution, or other preparations of iron. 

The clot in this instance is one that will be easily tolerated while that produced by 
the iron always acts as a foreign body, and is an ugly thing to contend with, to say the 
least of it; as the removal of the iron clot often results from secondary hemorrhage, 
whereas, the clot resulting from Peroxide of Hydrogen is tough, and capable of being- 
absorbed to a very great extent; or to say the least of it, its mechanical separation from 
the surrounding parts is much more easily accomplished than that of the iron clot. 

One point in particular must be remembered in the use of Peroxide of Hydrogen, 
that it must not be pent up. Its injection into the tissues always results in great pain, 
because of the undue distension produced by the gases. Hence, its injection into cav- 
ities where it can not have perfect freedom, may result disastrously in the production 
of great pain, to say nothing of what else might occur. 

* I have found none better than Marchand's. 



226 

In ordinary nose bleed, I know of no more valuable remedy than this agent. And 
indeed, in nose bleed, where there is rapid dripping or a small stream it arrests hem- 
orrhage within an incredibly short length of time. 

It should be used pure, or if it is desirable, first try it with equal parts of water. 
The best waj' to use it is to inject it with a small syringe, throwing in as much as half 
an ounce of the mixture at a time, directing it upwards at an angle of about forty-five 
degrees from the floor of the nose. This will insure it to reach almost every part of the 
interior surface of the nose. 

The patient's head should be inclined well forward so as to prevent any of the 
overflow going back into the larynx, which under ordinary circumstances would not be 
dangerous, but would be very unpleasant to the patient. 

The contact of the Peroxide of Hydrogen with blood results in immediate and rapid 
effervescence, just as it does when it comes in contact with pus. In using it for the pur- 
pose of arresting epistaxis, no attention need be paid to effervescence; just as soon as 
one syringe full has been discharged into the nose, follow it up immediately with 
a second and third syringe full. At this time it may be well to grasp the nose with the 
fingers and hold it for a moment, so as to give time for the perfect formation of the 
clot. 

If the bleeding surface is low down, and can be reached with a mop or cotton wool 
saturated with the peroxide, all the better. I rely upon it largely in office practice to 
arrest all ordinary nasal hemorrhage, and indeed I have arrested many cases of what 
may be termed extraordinary bleeding from the nose. It is reliable and safe, and far 
superior to any haemostatic that I know of, in arresting all forms of oozing hemorrhage 
from open surfaces. 



NOTES ON THE TREATMENT OF F^CAL FISTUL.T. 
By FREDERICK HOLME WTGGIN, M. I)., 

Visiting Gynecologist to the New York City, Hospital, and Visiting Surgeon to St. Elizabeth's 

Hospital. 

Abstract from the New York Medical Record, Oct. 14, 1896. 

At the thirteenth annual meeting of the New York State Medical Association, 
which was recently held in New York City, Dr. Frederick Holme Wiggin, of New 
York county, presented a paper with the above title. The chief cause of the occur- 
rence of foecal fistulse was stated to be the delay in resorting to operative measures to 
which patients suffering from typhlcenteritis, or strangulated hernia were frequently 
subjected while their ailment was carefully diagnosticated. The view recently advanced 
by a writer on the subject under consideration, that the best treatment for this con- 
dition consisted in its prevention, was concurred in. But in the case in which this 
mishap had occurred, it was pointed out that if the opening was of small size, was 
located near or below the ileo-caecal valve and no obstruction to the fsecal current existed, 
operative measures might be deferred, as in most instances the opening would close in 
a short time spontaneously. On the other hand, if the bowel opening was of large size, 
was situated laterally, or some distance above the ileo-caecal valve, and was accom- 
panied by the escape of a large proportion of the contents of the bowel, operative pro- 
cedure for the closure of the opening should be speedily undertaken. 

The histories of three cases, successfully treated by surgical measures were cited. 
In two instances, the patients were inmates of the Hartford (Connecticut) Hospital, 
and were operated upon by Dr. Wiggin, by reason of an invitation which was extended 
to him by the medical board of that institution, after several previous unsuccessful 
efforts to close the bowel openings had been made. The occurrence of the fistulous 



opening was due in the first case to failure, and in the second case, to delay in resort- 
ing to surgical treatment of typhloenteritis, from which disease both patients originally 
suffered. In the third case, the bowel opening was caused either by the pressure of 
the gauze used to drain the abscess cavity, or by an ulcerative process which originated 
from within the gut. In the first case, as the opening in the bowel was of large size, 
irregular in shape, and the gut was thickened and friable, the diseased portion of the 
bowel containing the opening, about four inches in length, was excised, and the divided 
ends joined by the suture method of Maunsell. In the second and third cases, the 
bowel openings were situated in the head of the colon, and were in both instances closed 
by means of several rows of sutures, after which the omentum was drawn over the 
former site of the fistula, and retained in position by sutures. 

In describing the technic employed, the writer laid much stress upon the follow- 
ing points, viz.: the thorough disinfection of the parts, including the interior of the 
bowel, with Hydrozone, the closing of the intestinal opening, when possible, before the 
breaking up of the peritoneal adhesions, and the opening of the general cavity, the 
removal of any existing obstruction to the faecal current, the disinfection of the bowel 
surface with a solution of Hydrozone, before and after the placing of the sutures, the 
control of oozing from the cicatricial tissue by the same means and the closure by a 
single row of silk-worm gut sutures without drainage of the abdominal wound after the 
washing of the peritoneal cavity with saline solution, some of which is allowed to remain. 

In concluding, the writer stated that ever since September, 1893, when he had 
proved the vaiue of Hydrogen Dioxide as an effective antiseptic, which in proper solu- 
tion did not unduly irritate the peritoneum, when followed by a six-tenths per cent, 
saline solution, he had had little reason to fear the danger of causing septic peritonitis 
from the accidental escape of pus or faecal matter while operating, and that when this 
complication had occurred , it had been invariably successfully met by the use of Hydrogen 
Dioxide in the manner described in the paper. He advised the excision of the diseased 
portion of the gut in those instances where it had become much thickened and friable, 
and expressed the belief that with a clearer understanding of the objects to be attained 
by operation — i. e., the restoration of the integrity of the intestinal canal, as well as the 
closure of the opening in the bowel — future operations for the cure of faecal fistulae would 
more frequently result successfully than they had in the past. 

The paper was discussed at some length by Dr. H. O. Marcy, of Boston, and Dr. 
Joseph D. Bryant, of New York county, who commended it and in the main, endorsed 
the writer's views. 



MAMMARY ABSCESS. 

By A. G. CALDWELL, M. D., of Ballard, Ky. 

Published by Louisville Medical Monthly, for November, 1896. 

One of the most troublesome complications of lactation is the formation of abscess 
in the breast; an occurrence we often meet, and which, if improperly treated, may by 
long continued suppuration and the formation of numerous sinuses in and about the 
breast produce very serious effects upon the general health, and even death by blood 
poisoning. The causes of breast abscesses are numerous, the most common being 
fissures or erosions of the nipples, hence those very common affections about the nipples 
should be promptly treated. The abscess may form in any part of the breast, or in the 
areolar tissue beneath it. Abscess is usually ushered in by a slight chill and general 
constitutional symptoms. These symptoms vary according to the severity of the inflam- 
mation. Fever is always present with rapid pulse and general malaise; rigors and 
sweats follow suppuration, and if not promptly treated at this stage it leads onto fistu- 



228 

lous tracts which in time completely riddle the breast. The general health soon suffers 
to a marked degree, and if it be left to suppurate for months the patient becomes 
reduced to profound and even dangerous debility. 

Treatment. — In many cases it may be aborted by removing the engorgement of 
the lacteal vessels by hand friction and saline cathartics, and giving the affected parts 
complete rest. When the general symptoms indicate the formation of pus, cleanse the 
breast thoroughly with antiseptics, and make a free incision at the most dependent part, 
parallel with the lacteal ducts to avoid injury to them. Avoid the admission of air, 
press out all the pus, then irrigate thoroughly with Hydrozone (Marchand's) and boiled 
water, equal parts, until foaming ceases; then inject the cavity thoroughly with a 5 
per cent, solution of carbolic acid, and if well done it seldom has to be repeated in acute 
cases. 

In chronic cases the same treatment suffices. When all sinuses and pus pockets 
are broken up so the Hydrozone can reach all parts, keep incision covered with anti- 
septic adhesive plaster and provide capillary drainage by inserting a strip of iodoform 
gauze. For the pain give opium, gentle salines for the bowels, and tonics for the 
general health. For high fever give large doses of quinine, and cactine to support the 
heart. 



PEROXIDE OF HYDROGEN IN DIPHTHERIA. 

By A. B. CLAY, M. D., Rutherford, Tenn. 
(Abstract of a paper read before the Gibson County Medical Society.) 

Diphtheria is a highly infectious disease, frequently assuming a severe epidemic 
form. Characterized by local fibrinous exudate, usually, though not always, upon a 
mucous membrane. There is strong reasons to believe that the infection is given off in 
the breath and various discharges. The sick should be isolated from the well ones, dis- 
infection of everything that has come in contact with the patient; when a death occurs 
from the disease the body should be thoroughly saturated with some powerful disin- 
fectant and placed in a coffin closely sealed, and the physician in attendance should 
request the family to have a private funeral. The infection lasts for an uncertain time 
after convalescence. 

This peculiar inflammation of the fauces is attended with the deposit of exudation 
which may locate at any one or more points, extend and coalesce so as to form extensive 
patches or cover the entire surface. The organs may suffer from considerable ulcera- 
tion or sloughing. Abscesses may form on any of the glands. In color the lymph 
may be gray, white, slightly yellowish, dark or dirty looking, greenish or gangrenous, 
and it may form in the throat from twelve to forty-eight hours after inflammation sets 
up. Should it be removed, a raw, bleeding surface is left, which is again speedily cov- 
ered by a fresh deposit, the exudation forming in the substance of, as well as upon, 
the mucous membrane, thus causing superficial destruction of the parts. There is 
constitutional disturbance which may become more or less severe, followed by nervous 
disorders. The patient whispers or cries with a husky voice, has a dirty-looking, 
opaque complexion, and the skin generally may assume a dirty, yellowish tint. There 
is an ordinary febrile attack. The temperature may rise to 103 or 104 . The pulse 
is rapid and feeble and the respiration hurried. The respiratory passage maybe 
involved. The invasion is generally gradual, there being a feeling of languor and ill- 
ness, more or less depression and weakness, often with chilliness, anorexia, nausea, 
diarrhoea, drowsiness, asthenic condition, dyspnoea, pulmonary complications, disten- 
tion of lungs, scanty or albuminous urine. Diphtheria is liable to occur in any season 
but prevails more in hot and dry seasons, when it often becomes epidemic, especially in 



229 

large centers of population. Now and then a sporadic form is met with. The con- 
tagion has not diminished in cities within the past few years like many other contagious 
diseases, although it frequently prevails with great severity in country districts. Prog- 
nosis, always grave, is worse in children than adults. The chief signs of danger are: 
Repeated vomiting or diarrhoea, epistaxis, great discharge from nares, implication of 
larynx, with consequent interference with respiration, a very rapid, feeble or infre- 
quent pulse, delirium, adynamia, suppression of secretion, prostration, cyanosis. There 
is no specific remedy for the disease. Lowering measures are not well borne, a support- 
ing treatment being always indicated. All hygienic conditions should be observed, the 
patient's room kept in a uniform temperature — 65 ° to 70 — and the air kept moist with 
steam. A generous diet — milk, eggs, soups, with stimulation, whiskey, brandy, 
ammonia — should be prescribed. Disinfectants should be freely used about the apart- 
ments. Mild purges, such as sulphate magnesia, seidlitz or phosphate soda, might be 
given beneficially. 

The use of drastic purgatives is to be deprecated. Calomel is highly recom- 
mended. Local treatment should be actively used. A great number of astringent and 
antiseptic preparations — such as nitrate of silver, tincture perchloride of iron, dilute 
hydrochloric acid, glycerine and carbolic acid, papoid in listerine — have been used with 
advantage. Spraying nose and throat by means of the atomizer is very efficacious. 
For this purpose the Peroxide of Hydrogen or Hydrozone (Marchand) diluted 
sufficiently or full strength, is very advantageously used. Two cases of the number 
reported were in an extreme condition and resisted the usual treatment. From the 
time the Hydrozone was used, the patients began to improve, and were soon in a state 
of convalescence. 



HYDROZONE 

FOR DISORDERS OF THE GENITO-URINARY TRACT. 

By JOHN AULDE, M. D., Philadelphia, Pa. 

Abstract from the Medical Times and Register, of Philadelphia, December 5, 1896. 

About eight years ago I was very forcibly impressed with the clinical properties of 
hydrogen dioxide through its prompt action in a case of protracted gonorrhea. The 
patient had suffered for about three months, and notwithstanding the most earnest solici- 
tations of several attendants the discharge had persisted. In addition to this, there 
was an orchitis present, the left testicle being about the size of a baseball. Treatment 
consisted of the local use of injections of equal parts of hydrogen dioxide and moderately 
warm water, used at intervals of four hours, these injections being followed by a solution 
of arsenite of copper containing one milligram (one 65th grain) to the drachm, diluted 
with an equal quantity of hot water.* The object of these injections was twofold: 
First, to cleanse the urethra by the destruction of micro-organisms, and second, to 
stimulate the functional activity of the epithelial cells, thus enabling them to resist the 
absorption of poisonous products. For the relief of the orchitis a suitable suspensory 
bandage was supplied, together with the local application of a stimulating ointment 
composed of mercury biniodide and lard, one part to ten. The ointment was applied 
at intervals of twenty-four hours for two or three times, when the swelling had percep- 
tibly diminished and convalescence had begun. 

In the course of a week this patient, who lived in a distant State, had so far recov- 
ered that he was able to return to his home, although he remained under treatment for 
a period of ten days, during which time the ointment was reapplied once. The dis- 
charge from the urethra had entirely ceased, pain had subsided and chordee had disap- 
peared . 

*See page 72.— When the urethra is very tender, Dr. Robert T. Morris recommends, that each 
injection should be preceded by cocaine or ether for the purpose of quietini? the smarting. 



2 3 

The same method of treatment is equally efficacious in the treatment of non-specific 
urethritis and ordinary forms of gleet, but as hydrozone is so much more concentrated 
and perfectly harmless, it should be given the preference over medicinal hydrogen 
dioxide. This will be understood when the advantages of using hot solutions are taken 
into consideration. Hot solutions of either hydrogen dioxide or hydrozone quickly 
liberate the nascent oxygen and thus diminish the activity of our medication. 

The value of this remedy is to be commended in the treatment of vaginitis 
and vaginismus; where hot solutions are especially indicated. Heretofore it has been 
the practice of physicians to recommend the employment of a hot vaginal douche, 
with or without some alkaline substance, such as sodium bicarbonate or boric acid, 
to be followed by a small quantity of medicinal Peroxide of Hydrogen combined with 
either warm or cold water; but with the increased volume of nascent oxygen con- 
tained in hydrozone a single application of the hot solution, one part to eight, will be 
found quite as effective. The patient should be taught how to employ the douche in order 
to obtain the best results. She should have a fountain syringe, in which the medicated 
solution is placed; it is then hung upon the wall at a distance of six feet from the floor 
and the patient sits upon a suitable vessel. The rubber tip of the hose is then introduced 
well back into the vaginal cavity, so as to avoid introducing the solution into the uterine 
cavity, and with the fingers of the disengaged hand the patient compresses the labiae, 
allowing the medicated solution to distend the vaginal cavity, by which it is brought 
into contact with every portion of the diseased tissues. This plan should be repeated 
at least twice in twenty-four hours. 

In the treatment of uterine disorders, where it is necessary to bring the medicated 
solution into contact with the lining membrane of the uterus, the patient should be 
placed in the recumbent position, with the hips well elevated as in the case of other 
uterine applications. An ordinary dilatation is then employed to distend the cervix, so 
as to permit the introduction of the nozzle of the syringe. The distension should be 
sufficient to permit the exit of the injected solution, or a suitable return-flow tube can 
be used instead. Certain precautions are necessary in making these applications, espec- 
ially in chronic cases, because the effervescence attending the destruction of unhealthy 
mucus in the uterine cavity may be sufficient to drive a small portion of the debris into 
the Fallopian tubes. This danger, however, can be reduced to a minimum by the 
liberal use of the hot medicated solution and afterwards instructing the patient to sit 
up in bed. The pressure thus brought upon the uterus is sufficient to cause the dis- 
charge of all debris resulting from this application. 

In this class of cases it is of the utmost importance that none of the vaginal secre- 
tions should be permitted to enter the uterine cavity, which can be avoided by having 
the patient take a preliminary vaginal douche, using the medicated solution. Where 
this cannot be accomplished, or seems unnecessary, the vaginal tract should be cleansed 
by the local use of the medicated solution after introducing tht speculum. 

A word of caution should be added in regard to the vaginal douche. Where the 
cervix is patulous and the patient takes the vaginal douche in the recumbent posture, 
using the precaution above described to insure the full distension of the vaginal cavity, 
a portion of the debris would almost certainly find its way into the cavity of the uterus, 
and with it probably more or less of the poison, and thus we have uterine disease super- 
added to the vaginal affection. Undoubtedly many cases of uterine disease have resulted 
from a failure to observe this precaution. 

Diluted hydrozone will be found an efficient remedy for the relief of cystitis occur- 
ring either in the male or female. In chronic cases the amount of the solution (i to 8) 
must be limited, owing to the thickening of the walls of the bladder and the pain result- 
ing from the muscular contractions after the withdrawal of the solution. Gradually how- 
ever, the amount of the solution can be increased. In addition to the local treatment 
of cystitis and gleet, and sometimes in chronic cases of gonorrhea, much benefit will be 
derived from the internal administration of calcium sulphide, about one-tenth grain, at 
intervals of two hours. 



2 3 I 

SYPHILIS SUCCESSFULLY TREATED BY HYDRIATICS. 

by ELMER LEE, A. M., M. D., Ph. B. Chicago, III. 

Read in the Section on Dermatology and Syphilography at the Forty-seventh Annual 
Meeting of the American Medical Association, at Atlanta, Ga., May 5-8, 1896. 

(Reprinted from the Journal of the American Medical Association, December 12, 1896.) 

There is, perhaps, no disease whose character is so black, and whose ravages ar e 
so universally distressing as that under consideration. The name syphilis strikes terro r 
into the soul of its victim, and measureless uncertainty in the mind of the professional 
attendant upon whose shoulders the responsibility of treatment is placed. 

The exact origin of syphilis is uncertain. The records do not clearly establish by 
whom or at what time in the history of the world the disease was first discovered. There 
has been much discussion concerning this point, but little satisfaction has resulted. It 
is the common habit of the Europeans to associate the disease with the return of the 
followers of Columbus, in 1493, from their discoveries of the West Indies. However, 
this may be, without the shadow of a doubt, the same disease must have existed 
centuries before among the races of the Orient. The first record of syphilis in France 
dates only to the siege of Naples, in 1494. 

Syphilis is spread by direct contagion upon an abraded surface or a breach in an 
exposed membrane or tissue, and thereby, contaminating virus enters the system. A 
period of variable duration between the inception by contact and the lesion follows. It 
may be a few days, or it may be weeks before the systemic exhibitions appear. Two 
reasons may be assigned for the variability of incubation, viz. ; the virility of the poison 
and the susceptibility of the individual. As in other diseases, there are some people 
insusceptible to syphilitic virus. 

The precise nature of the infecting virus has eluded the researches of scientific 
processes of determination. It is an open question whether the serious poisoning which 
results is caused by a direct entrance of the contagion into the circulation, or whether 
it is by reason of the secondary absorption of the product of the initial ulcer. For my 
part it is not possible to decide the question, but fortunately the practical treatment of 
the disease does not depend upon this mooted point. The answer to the problem is, 
probably, that both influences together produce the result. 

The first manifestation of syphilis appears in the form of macule or papule upon 
some mucous or skin surface. The lesion may extend quickly to the deeper tissues and 
viscera. During the period of healing of the initial lesion, the disease is regarded as in 
the first stage. The subsequent appearance of surface and other lesions constitute the 
second period of syphilis. If there are still subsequent exhibitions at some later time, 
usually measured by years, such a manifestation establishes the third period of the dis- 
ease. 

One invasion of the body generally precludes a second. The disease may be 
transmitted by the secretions of a sore upon any part of the body within and during the 
earlier stages. The power of transmission during the third period of the disease is 
regarded as unlikely, although there are some differences of opinion on this matter. It 
is, further, reasonably decided that the normal secretions of the. body, such as saliva, 
mucus and other fluids do not transmit the disease. But in the first stage of syphilis 
the blood as well as the material from the initial lesion may infect another person. 

Some investigators have asserted that a germ has been found constantly associated 
with the blood during the earlier stages of this disease, and that the microphite destroys 
both the white and red corpuscles. As in some other diseases, the symptoms 
of this are similar to those of certain other forms of toxemia. But it is undoubtedly 
true that syphilis is due to a definite and specific contagion. The blood is poisoned 
thereby, and a series of mild or severe disturbances of the health ensue in a somewhat 
regular order. The principal changes that occur, according to Virchow, begin by the 
production of a small-celled solid growth, which at first resembles granulation tissue, but 



232 

which soon shows a vesicular occlusion with consequent degeneration. This statement 
is, to me, one of the most important in the pathology of syphilis. If studied, according 
to the light of experience and analogy, it has the significant indication pointing out the 
requirements for treatment. 

Variation in the caliber of the minutest channels through which the circulation is 
carried, forms the earliest pathologic manifestations in internal diseases. The recog- 
nition of this fact is of the greatest significance in the direction of a correct under- 
standing of the truth concerning pathologic conditions. Alterations in the size of the 
vesicular spaces produce either congestion or hyperemia, either state producing destruc- 
tive changes in the delicate cell structures. Should the disturbance in the circulation 
occur in the cells of a vital organ, the influence upon the whole body will be proportion- 
ately serious. If at the same time, the resisting power of the general system as well as 
the special locality in which the lesion occurs, should be of low vitality, great struc- 
tural changes necessarily follow within short periods of time. 

In the treatment of syphilis there is always one imperative indication, namely, sus- 
taining the natural resisting forces against auto-infection. Upon the weakened and 
demoralized system, disease preys rapidly and furiously. It is more important to pre- 
serve the integrity of the individual cell, by supplying it with natural nutrition, and 
relieving it of the occlusions in its neighborhood, than it is to attempt to overwhelm the 
circulation by some extraneous and poisonous material with the view of neutralizing a 
virus of disease. It is a serious question whether an organic or inorganic chemic sub- 
stance, pervading any part of the living tissue structures, is able to be neutralized by the 
introduction of another chemic agent. The various organic and inorganic drugs used 
for the treatment of syphilis are based upon the supposed property of a matter to destroy 
or antagonize another. It is easy to produce a definite reaction under favorable con- 
ditions in a physiologic or chemic laboratory when we know the exact nature of the 
materials with which the experiment is conducted; definite reactions, however, in living 
structures are not possible. 

The influence upon the contagion which enters the circulation from without, by the 
fluids and solid elements of organized living tissues, cannot be definitely determined by 
scientific methods. Moreover, when a given mineral or vegetable reagent enters the 
stomach, and during its passage through the system, it is lost to the senses cf the 
scientist, consequently whatever reactions there may be are determined by no reliable 
data. It was recently stated by a clinician who gives nearly all his time to the treat- 
ment of syphilitic manifestations, tnat up to the present moment, the materia medica 
offered but two agents with which to control the symptoms of this disease. 

Forlunately, indeed, it would be did the materia medica possess so many as two 
remedies, which could, in truth, cure syphilis. Every physician whose experience has 
been even moderate, knows that mercury and iodid of potassium are not able to cure 
syphilis, all that may be said to the contrary notwithstanding. The philosophy of a 
cure of the impaired tissues, by further impairment of that tissue is allopathy, but it is 
not true to nature. It is necessary to do more than conform to a theory included within 
the confines of a name. Syphilis is not curable by the alleged principles of "allopathy," 
or the infinitesimal folly of "homeopathy," or by the vagaries of the "eclectics." If 
the disease is curable, the remedial forces of that inherent tendency for good which 
resides in every vegetable and animal cell are able, when properly aided, to conquer 
against its enemies. 

By reference to one of the most recent reviews concerning the latest improved 
treatment of syphilis, the following remedies are advocated as essential: The list com- 
prises blue pill, gray powder, gentian, quinin, iron, opium, alum, chlorate of potash, jalap, 
gamboge, epsom salts, green iodid of mercury, perchlorid of mercury, iodid of potas- 
sium, perchlorid of iron, red iodid of mercury, tannate of mercury, sarsaparilla, anti- 
mony, aromatics, iodid of sodium, iodid of ammonium, carbonate of ammonia, tartar - 
ated iron, bitter infusions, arsenic, iodid of mercury, iodoform, bromid of potassium, 
bromid of sodium, bromid of ammonium, strychnin, cod liver oil. mineral acids, vege- 



233 

table bitters, sulphur, calomel, black wash, carbolic acid, ointment of ammoniated mer- 
cury, ointment of oxid of zinc, mercurial ointment, mercurial vapor bath, borax, chromic 
acid, permanganate of potash, iodoform ointment and atropin. 

Of this bewildering array of anti-syphilitic soldiers, how is the young doctor to dis- 
cover who is general and which are privates? The life of a physician is too short to exam- 
ine each remedy and calculate its value. The numerous remedies really constitute a 
disadvantage to the patient as well as the doctor. The choice of the materia medica will 
be determined very iargely by the number of years since the date of graduation. The 
lectures emphatically encourage the necessary use of mercurials, and with this recom- 
mendation in mind, the young medical man feels consciously strong in his ability to treat 
syphilis. He is encouraged to think that while there is difference of opinion concern- 
ing the use of medicines in the treatment of whooping cough and measles, that the pro- 
fession is a unity in its approval of mercurial treatment of syphilis. When a few cases 
have been entrusted by chance or some other influence to his care, doubts will come 
into his mind and his security will be sadly disturbed. 

In what way is syphilis pathologically and radically different from other functional 
and organic diseases, that it may not be cured? There are conditions which we fre- 
quently see that are quite incurable, both in this and in other diseases. When the degen- 
erate tendency becomes stronger than the resistance of the cells can endure, the natural 
termination of such cases is fatal. Other cases are incurable because of the utter wil- 
fulness and disregard of reason by the patient. 

The experiences of the profession clearly show that the natural termination of 
syphilis is toward recovery. The disease may be light or otherwise and in either case 
complete restoration often takes place, either with or without professional treatment. 
It would seem to show that if a single case of either mild or severe syphiiis recovers with- 
out treatment, that the restoration is solely due to the principle of inherent preservation of 
cell integrity through a natural agency. My line of experience has taught forcibly the 
lesson that vitality maintained through physiologic and hygienic management is a scientific, 
a safe and satisfactory treatment of syphilis in the earlier stages. In the last stages, and 
when the forces of life are sadly weak and declining, it is worse than useless to hope for 
honest relief through the administration of organic and inororganic substances. 

It is, perhaps, rash to controvert the position of the general profession in its atti- 
tude favoring the use of mercurials in the treatment of syphilis, and it would have been 
unnatural to an orthodox medical education, prior to the last third of my medical career. 
But it matters not, rash or otherwise, the only concern of the physician is to know the 
truth, and if syphilis can be successfully treated by hydriatics, is it not a worthy triumph? 
The treatment of syphilis by water as the principal remedial agent, is not so simple or 
so well known as the agent itself would seem to indicate. Neither is the method 
mysterious or devious. But it must be mastered, and experience will teach more than 
may be learned from a study of the brief literature on this subject. 

My attention became attracted to hydriatics, as a successful method of treating 
syphilis, through the necessity of personal responsibility in the treatment of this disease. 
My position has been gained by actual clinical experience. 

There came to my office in the spring of 1895", a negro, George F., age 25, single, 
waiter, who applied for relief on account of phimosis. The symptom which lead him 
to consult me was inordinate accumulation of smegma. Circumcision was done and the 
case disappeared from my observation. Perhaps a month later, the patient appeared 
again to exhibit an ulcer located on the dorsum, at the point where the division had 
been made. This ulcer was enormous before it healed and was characteristic in every 
particular. Finally it healed, and some weeks subsequent to its cicatrization, the 
negro returned with unmistakable secondary symptoms of syphilis. The rash was 
typical, the knees and ankles were swollen and painful, and the indications upon the 
exposed mucous membranes were indicative of contagion poisoning. 

The treatment was instituted from the inception of the diagnosis. The case was 
seen by several experienced confreres, and the plan of management as outlined, was 



234 

watched by them as well as by myself. The agreement in diagnosis was emphatic. 
Water was the remedy prescribed in regulated doses to the extent of between two and 
three liters per day during a period of between eight and ten months. In each glassful 
of water some harmless dose of medicine was incorporated for the purpose of producing 
the desired mental effect upon the patient. The agent used for this purpose consisted, 
for the most part, of one or two drops of carbolic acid to six or eight ounces of water, 
which was altered in color each time the prescription was refilled. The dose from the 
bottle was a teaspoonful, to be mixed with the portion of water which was to be taken 
at definite intervals during the day. There was a period of two weeks, during the 
second month of the treatment of the disease, when the young man was unable to work 
on account of the unsightly appearance of his face and hands, as well as the general 
discomfort from which he suffered. The symptom which remained the longest was 
edema of the ankles. It has, however, entirely disappeared at this time. The symp- 
tom of next longest duration was the raised patches, some of which broke down, 
covering the unexposed surface of the body. The negro at this time is free from any 
discoverable lesion or symptom of syphilitic sequelce. The skin is smooth and the 
discolorations have practically disappeared. The case has frequently been observed by 
several physicians, and at the last visit to my office, he was pronounced cured so far as 
symptoms could be discovered. 

During the winter of 1894-95, a woman, Lizzie B., singles 26 years old, fair, a 
stenographer, presented an ulcerated throat. The case was not suspicious, and the 
ulceration was considered benign; simple treatment was begun. A few weeks later she 
complained of vesical hemorrhage. Examination revealed erosion of, and an ulcer upon 
the inner surface of the anterior lip of the cervix. The case was immediately suspected 
to be a contagious disease. At that time, no personal interrogation of her previous con- 
duct took place; for a period of several weeks the case was observed and the diag- 
nosis gradually and emphatically determined to be syphilitic. Soon after this deter- 
mination, she was confined to her bed with fever, and during this time secondary erup- 
tions manifested themselves in the form of papules. They broadened and extended 
over the whole body. The hair fell out in considerable quantity. 

Her treatment, with the exception of local applications to the cervix, was directed 
in the same general line as in the preceding case. The patient, however, during all 
this period of treatment, which covered perhaps ten months, regularly added tea- 
spoonful doses of the scented and colored water from the druggist's prescription bottle 
to the doses of water which were given her at stated intervals, and in sufficient quantity, 
during each day of the ten months. 

In addition to internal hydriatics, the bowels were irrigated daily during a period 
of the first three months of treatment. Subsequent to that time, irrigation was per- 
formed at intervals of once each week. The recovery of this woman is satisfactory to 
herself, and no physical symptoms of syphilis can be found. 

The local treatment consisted, principally, of Hydrozone applied in full strength 
to the chancres in each case. Hydrozone is selected amongst antiseptics, for the 
reason that it exceeds all others in rapid oxidation, with veritable destruction of micro- 
phites and putrid matter. In syphilitic treatment, the strongest antiseptic is most 
desirable, if at the same time, it is safe and effective. The surface eruptions on the 
body were anointed with Elixo, a liquid soap, which was rubbed in till it was dry, and 
allowed to remain until washed off at the bath the following day, to be again rubbed in 
as before; a substitute for blue ointment. 

In conclusion, the heralded treatment of syphilis at water cures, such as Hot 
Springs, Ark., and other places of the same character, are, in my opinion, dependent 
upon the quantity of water which is used, internally and externally, and not upon the 
quality. Furthermore, the relief of the symptoms is dependent upon the large and 
regularly used internal hydriatics, and not upon the morbid effects produced by the 
mineral and vegetable materials which are administered in enormous and destructive 
doses. By reason of the preservation of the functions of the vital organs, through the 



2 35 

internal use of water and the external baths, nature withstands and permits the awful 
abuse to which it is subjected by the mercury and iodid of potassium that are imposed 
upon credulous patients. 
103 State Street. 

PATHOLOGY AND TREATMENT OF INDOLENT ULCERS. 

By DRS. P. N. RUSSELL, G. H. AIKEN and A. J. PEDLAR, 
of Fresno, Cal. 

Published by the Occidental Medical Times, of Sacramento, Cal., for December, 1S96. 

Read before the San Joaquin Valley Medical Society, October 28, 1896. 

Anything which produces injury, irritation, or friction, may cause these ulcers. 
They are frequently associated with varicose veins. In treating the ulcer, the first 
requirement necessary to induce healing is to arrest the disintegration, and next, 
to make the ulcer assume a clean and healthy granulating surface. Support of the cir- 
culation was an important point. For this purpose he frequently curetted the surface 
and sometimes made radiating incisions through the indurated edges. After thoroughly 
cleansing the surface he next disinfected the cavity and then applied a simple ointment 
to the skin for a considerable distance around the ulcer, filling the excavation with 
iodoform. Over this he applied a piece of gutapercha tissue, in which numerous holes 
had been punched, and then a rubber bandage. This he regarded as the most important 
part of the treatment. It was applied carefully, including the foot, and going above the 
ulcer. Each case should be dressed, according to its condition, from every day to twice 
a week. The rubber bandage was removed on going to bed and reapplied on rising. 
The treatment was sometimes supplemented with an occasional mopping out of the 
ulcerated surface with hydrogen peroxide (Marchand's). In addition to local measures, 
the general condition should carefully be looked after, constitutional treatment being 
given if necessary 7 . 

Dr. G. H. Aiken, of Fresno: The general outline of the author's treatment is 
excellent. What we have to do is to convert the unhealthy, diseased condition to that 
of healthy tissue. Aside from that, when accomplished, we may have a large denuded 
surface requiring epithelium and new skin. How shall we best achieve this? I have 
tried several methods with bandaging and antiseptic dressings, but recently, with a 
severe and indolent ulcer from varicose veins, I adopted the following plan: The ulcer 
was about the size of a silver dollar, of a gray, dirty color, with indurated edges. I 
cleansed the parts with Peroxide of Hydrogen (Marchand's), which I find to be most 
effectual in destroying these necrosed conditions, and then dusted the surface with iodo- 
form until it became a healthy granulating surface. How shall we heal these ulcers 
rapidly? I have found pyoktannin to be very effectual. I touch the whole surface 
with it, then apply white vaseline with campho-phenique; and over that iodoform gauze, 
and perhaps a little absorbent cotton, then bandage from the foot to the knee with an 
ordinary bandage. I allow the dressing to remain three or four days. It is astonish- 
ing to see the rapidity of cicatrization under the treatment. Each time when dressing, 
I apply the blue pencil. 

Dr. A. J. Pedlar, of Fresno: I do not think I have found any one remedy that 
can be relied upon in these ulcers. In some cases I would get good results, and with 
the same treatment, fail in others. I have used protonuclein with benefit in chronic 
ulcers. Last summer, during the extreme heat, I treated a woman upwards of 60 years 
of age, and weighing about 200 pounds. She was doing her own house work, and in the 
almost incredible short time of two weeks I healed a large ulcer of the leg, which was 
troubling her for about two years. I cleansed the surface with Peroxide of Hydrogen 
(Marchand's) and applied protonuclein and absorbent cotton and bandaged above the 
swell of the calf. I have used it since, in the office, with good results. 



236 

LOCAL TREATMENT OF CHRONIC GASTRIC CATARRH— 
A CLINICAL LECTURE. 
By J.M. G. CARTER, M. D., Sc. D., Ph. D., 

Professor of Clinical and Preventive Medicine in the College of Physicians and Surgeons, Chicago 
Fellow of 'the American Academy of Medicine, etc. 

(Reprint from the American Therapist, January, 1897.) 

Local treatment may be applied in any stage of chronic gastric catarrh; but it must 
be varied somewhat in the different stages. The grade of inflammation, its character 
and persistence, likewise may require some modification of the treatment. 

First stage. — During the insipiency of chronic gastritis, local treatment is not so 
essential, except in bacterial cases, but is beneficial. It serves to modify the congestion 
when that is increased, and often allays dyspeptic symptoms even when they are more 
marked than usual. The use of warm water (105) with bicarbonate of sodium (three per 
cent.) for washing out the stomach is frequently very valuable to remove the tenacious 
mucus usually adhering to the gastric mucous membrane, in this condition, and interfering 
with the proper mixing of peptic fluid with the food. The patient may drink a glassful 
of the solution before meals or it may be introduced into the stomach through the tube. 
If the tube is used, the stomach should be filled before allowing any reflow. The cold 
douche with water at 8o° to 6o° is sometimes more grateful and helpful than the hot 
douche (no° to 125 .) A continuous effect may be secured by using a double tube 
and permitting the inflow and outflow to progress simultaneously; but care should be 
taken to keep the stomach distended sufficiently to have the solution come in contact with 
the entire gastric surface. The soda solution dissolves the mucus and the stream 
washes it away. Weak soap-suds may be used with the tube for the same purpose. 
More satisfactory in many instances is the use of a solution of Ilydrozone. A glass- 
ful (fl 3 viii) of a two or three per cent, solution may be given half an hour before meals. 
If used as a douche with the tube a five or six per cent, solution is not too strong, and 
two quarts the minimum amount. These douchings may be given one to six or seven 
times a week, according to the requirements of the case, and are frequently all the treat- 
ment this stage of chronic gastritis demands, except what changes are necessary in the 
diet. 

Second stage. — The inflammatory process is fully developed in the second stage and 
while there may be weeks or months when there is little if any suffering, the treatment 
should be persistent. The cleansing of the gastric mucous membrane must be system- 
atic and thorough. This is best accomplished with a solution of green soap or a five 
or eight percent, solution of Hydrozone, introduced with the double tube. After first 
filling the stomach, inflowing and outflowing streams ought to remain about equal or 
the outflow may exceed the inflow, the distention of the stomach may be maintained by 
retarding the reflow when necessary. This process can be beneficially accomplished bv 
driving the solution into the stomach under increased air pressure; but when the proper 
apparatus for this method is not at hand the siphoning method with the single rube 
does very well. For home treatment or when the tube cannot for any reason be used 
a solution may be made for drinking. For this purpose a 2 or 3 per cent, solution of 
Hydrozone is prepared. The patient may take a glassful (8 oz.) half an hour before 
meal time. He should lie down at once, remain five minutes on the back, then turn on 
tha right side where he must remain during the remainder of the half hour. While the 
patient is on the back the solution comes in contact with every portion of the gastric 
mucous membraneand turning to the right side facilitates the emptying of the stomach. 
By this process the offending mucus is dissolved and carried away and the organ is put 
into a proper condition to digest food. The use of Hydrozone has the additional 
advantage of checking the growth of the bacteria, and probably exhibits greater anti- 
septic properties than any other agent that can be used in the stomach with the same 
degree of safety. In obstinate cases this cleansing ought to precede every .meal. 



^37 

After the stomach is cleansed it should be treated with soothing, stimulating and 
healing applications. There are many preparations which can be so used, some of the 
best of which are glycerole of bismuth and eucalyptol, the essential oils and Glycozone. 
Boric acid in 2 or 3 per cent, solution as a wash with the tube is sometimes very valu- 
able. The other agents mentioned may be used with a nebulizer by means of which 
a vapor impregnated with the medicines can be passed into the stomach through a 
tube, the double tube being preferable. If it is not convenient to use a nebulizing appa- 
ratus, the glycerole mentioned, and especially Glycozone, may be administered by the 
mouth. In many cases, in fact, the latter mode of administering these agents is more 
desirable. These remedies encourage healing and materially enhance the patient's 
prospects of recovery. This is especially true in bacterial cases. When Hydrozone 
has been given before meals as already suggested for cleansing purposes, Glycozone 
may be administered in teaspoonful doses after meals with very satisfactory results. 
This line of treatment is frequently so successful that cases are temporarily relieved 
and possibly often a cure effected, particularly if the general treatment has been judici- 
ously carried out. 

If, for any reason, Glycozone cannot be employed the essential oils may be used. 
The oils of anise, peppermint, cubebs, and tar may be combined and used with a 
nebulizer as previously suggested. Although benefit may be derived from the admin- 
istration of this combination, I prefer Glycozone treatment. The use of hot water, 120° 
or more, and the employment of cold water, 8o° to 40° (F.) may give very happy results 
in certain severe cases. 

Third stage. — The condition referred to here is one of atrophy. The functions 
of absorption and motion may be fairly well performed. The chief difficulty then is 
with the digestion of proteids. The local treatment has two objects mainly, although 
a third is sometimes in mind. The first object is the removal of debris and foreign 
material. The second is the cleansing of the mucous membrane and the destruction of 
micro-organisms and their removal in order that the intestines may not receive bacterial 
products from the stomach. The third object sometimes kept in view in the local 
treatment by douching is a degree Of stimulation of the functions of motion and absorp- 
tion and the tonic effect to the gastric walls which follow those washings. The first 
object is accomplished by the use of sterilized water or a 3 per cent solution of sodium 
bicarbonate. Either tube may be used. The second object is effected by douching 
the walls with a green soap solution or a solution of Hydrozone. The latter agent in 
5 per cent, solution as directed above gives very pleasing results. The third object 
may be secured by using hot or cold water for the douche. 

100 State Street, Chicago. 



MECHANICAL FEEDING IN THE INSANE. 

By FRANK C. HOYT, M. D., Clarinda, Iowa. 

Superintendent Iowa Hospital for the Insane. 

Published by The Medical Herald, of St. Joseph, Mo., January, 1897. 

In many forms of insanity, but particularly in cases of stuporous melancholia, and 
melancholia with extreme agitation, we find our patients suffering with gastric dis- 
orders, which require prompt and methodical treatment. These gastric derangements 
are usually to be classed as atonic dyspepsia, with hypersecretion, or chronic mucus 
gastritis, also attended by hypersecretion. In the latter condition we find that decom- 
position, with a consequent formation of gas, takes place; the decomposing food acts 
as a powerful irritant to the mucosa of the stomach, there is a corresponding increase 
of the muscular action of the sphincters; the resulting contraction causes a retention of 



238 

the decomposing food, while the gaseous distension seems to distend and paralyze the 
walls of the stomach. Patients so afflicted usually refuse food, not alone on account of 
their mental apathy, but because the ingestion of food causes pain and discomfort. 

Where in ordinary cases we could safely treat the gastric disturbances systematically, 
and, to a certain extent, leisurely, yet in cases of alienation the destructive metabolism 
is so great as to force us to secure a restoration of the functions of the stomach as 
rapidly as possible. Rectal alimentation may be used in these cases, but for obvious 
reasons is very unsatisfactory. In common practice it has been the rule to permit the 
patients to take food — predigested, it is true — whenever they could be induced to do so, 
resorting to mechanical feeding only when necessary to introduce food. 

This practice is erroneous, however, in my opinion, and I wish to advocate the use 
of the lavage tube and mechanical alimentation in all cases of insanity, in which there 
is established a diagnosis of atonic dyspepsia, or in fact any form of gastritis in which 
there is a retention of mucus or food, with consequent decomposition. 

The plan of treatment I would outline as follows: Twice or three times daily the 
stomach should be thoroughly cleansed by a large volume of warm ozonized water, pre- 
pared by adding three ounces of Hydrozone (Marchand's) to one gallon of water. This 
should be poured into the stomach slowly, giving time for escape of gas through the 
tube, until the stomach is about one-third filled. The fluid, decomposing food, mucus, 
etc., should then be permitted to escape, and the same procedure repeated, until the 
fluid comes away clear and free from gas bubbles. Then empty the stomach com- 
pletely, and introduce a proper amount of prepared food, such as malted milk. The 
opportunity may also be taken to administer such therapeutic agents as may be indi- 
cated, small doses of Glycozone seeming to favor a restoration of the normal function 
of the stomach. 

In this connection, however, I wish to say that no greater mistake can be made in 
the treatment of these cases, than to crowd an already disabled stomach with food and 
medicine, before it is cleansed of its foul load of decomposing matter, and its mucosa 
put in a condition favorable to digestion and absorption. And I would also say that 
I know of no agent that equals Hydrozone for cleansing purposes. 



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i-i lb. Bottle C. P. Glycerine, 
i-Hand Atomizer and Ozonizer, 

$5.00. 



i-Large Size Bottle Hydrozone, 
i-i lb. Bottle C. P. Glycerine, 
i-Hand Atomizer and Ozonizer, 

$5-25- 



MARCHAND'S MEDICINAL PREPARATIONS. 



PEROXIDE of HYDROGEN J 1-4 lb 

(Medicinal) 15 Volumes H 2 2 . ) 1-2 lb 



Smallest size for Dentists, per bottle, $0 25 



GLYCOZONE 



lb. 

1-4 lb . 

1-2 lb . 

1 lb. 



HYDROZONE (30 Volumes H2 O2) 



( Ext. Small size for Dentists 

) Small size 

j Medium size 

( Large size 

EYE BALSAM Per Bottle 



HAND ATOMIZER AND OZONIZER Each 

LABORATORY. 

28 Prince Street, New York. 






5<-> 





75 


I 


00 


" I 


00 


I 


75 


3 


00 





25 





50 





75 


1 


25 





50 


3 


50 



When you cannot procure the above medicinal preparations in their 
original unbroken packages at your druggist, send money order to 
CHARLES MARCHAi\ T D, at the above address and shipment will be 
made by express. 

Once a bottle has been opened by a druggist, I decline to guarantee either 
one or the other of these remedies as being genuine. 

NOTE. — One extra small size bottle of Hydrozone will be sent by mail 
on receipt of money order for 25 cents 

One 4 oz. bottle of Glycozone will be sent by mail on receipt of money 
order for $1.00. 

One bottle of Marchand's Eye Balsam will be sent by mail on receipt of 
mon?y ord^r for 50 cents. 

Should vou have been imposed upon by any one who substituted spuri- 
ous preparations instead offthe genuine article, please report to me, so that 
I may expose a.id prosecute such fraudulent dealers. 



v OF C 

BINDERY 

1903 



LIBRARY OF CONGRESS 

OOOESfl^OSa 1 ! 



